Endocrine Late Effects in Childhood Cancer Survivors
Ce dossier présente les enjeux liés à la survenue à long terme et à la prise en charge des effets indésirables des traitements anticancéreux chez des patients ayant survécu à un cancer diagnostiqué pendant l'enfance, l'adolescence ou au début de l'âge adulte, et évalue l'impact de ces effets indésirables sur la qualité de vie, sur la survie et sur les besoins médicaux et psychosociaux associés
Endocrine complications are highly prevalent in childhood cancer survivors. Approximately 50% of survivors will experience at least one hormonal disorder over the course of their lives. Endocrine complications often are observed in survivors previously treated with radiation to the head, neck, or pelvis. We provide an overview the most common endocrine late effects seen in survivors, including hypothalamic-pituitary dysfunction, primary thyroid dysfunction, obesity, diabetes mellitus, metabolic syndrome, and decreased bone mineral density. Primary gonadal injury is discussed elsewhere in this series. Given a variable latency interval, a systematic approach where individuals are periodically screened on the basis of their risk factors can help to improve health outcomes by prompt diagnosis and treatment of evolving endocrinopathies. These recommendations must be revised in the future given changes and improvements in cancer treatment over time.