ERİŞKİN YAŞTA GELEN ÇOCUKLUK ÇAĞI VE ADOLESAN KANSER
HASTALARINDA DİĞER NONREPRODÜKTİF ENDOKRİN
ANORMALLİKLER
Erişkin yaşa gelen çocukluk çağı kanser hastalarında tedaviye bağlı olarak pekçok sitemik ve endokrin bozukluk izlenmektedir. Malesef kız cinsiyet bu olumsuzluklardan daha fazla pay almaktadır. Özellikle kraniospinal radyasyon sonrası, kognitif bozukluklar, obesite, kardiovasküler hastalık, pubertenin zamanlamasına aksaklık, tiroid fonskiyon bozuklukları, iskelet büyümesinde gerilik bunlardan bir kaçıdır. Bu bülümde bu hastalarda uzun dönemde görülen üreme dışı endokrin anormallikler işlenecektir.
OTHER LONG-TERM ENDOCRINE
ABNORMALITIES IN THE CHILDHOOD
CANCER SURVIVORS
There are numerous treatment-related risks for long-term adverse outcomes among survivors of childhood cancer after exposure to chemotherapeutic drugs and radiotherapy. Sadly, It appears that female sex is more commonly associated with treatment related risks such as cognitive dysfunction after cranial irradiation, poor cardiovascular outcomes, obesity, radiation-associated differences in pubertal timing, development of primary hypothyroidism, impaired skeletal growth breast cancer as a second malignant neoplasm, and osteonecrosis.
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- 1. Oeffinger, K C, Mertens, A C, Sklar, C A, et al., Chronic
health conditions in adult survivors of childhood cancer.
N Engl J Med 2006; 355: 1572-82.
- 2. Chemaitilly, W and Sklar, C A, Endocrine complications
in long-term survivors of childhood cancers.
Endocr Relat Cancer 2010; 17: R141-59.
- 3. Diller, L, Chow, E J, Gurney, J G, et al., Chronic disease
in the Childhood Cancer Survivor Study cohort: a
review of published findings. J Clin Oncol 2009; 27:
2339-55.
- 4. Armstrong, G T, Whitton, J A, Gajjar, A, et al.,
Abnormal timing of menarche in survivors of central
nervous system tumors: A report from the Childhood
Cancer Survivor Study. Cancer 2009; 115: 2562-70.
- 5. Oberfield, S E, Soranno, D, Nirenberg, A, et al., Age at
onset of puberty following high-dose central nervous
system radiation therapy. Arch Pediatr Adolesc Med
1996; 150: 589-92.
- 6. Berberoglu, M, Precocious Puberty and Normal
Variant Puberty: Definition, etiology, diagnosis and
current management. J Clin Res Pediatr Endocrinol
2009; 1: 164-74.
- 7. Green, D M, Sklar, C A, Boice, J D, Jr., et al., Ovarian
failure and reproductive outcomes after childhood cancer
treatment: results from the Childhood Cancer
Survivor Study. J Clin Oncol 2009; 27: 2374-81.
- 8. Byrne, J, Fears, T R, Mills, J L, et al., Fertility in women
treated with cranial radiotherapy for childhood acute
lymphoblastic leukemia. Pediatr Blood Cancer 2004;
42: 589-97.
- 9. Taylor, R E, Cancer in children: radiotherapeutic
approaches. Br Med Bull 1996; 52: 873-86.
- 10. Gurney, J G, Ness, K K, Stovall, M, et al., Final height
and body mass index among adult survivors of childhood
brain cancer: childhood cancer survivor study. J
Clin Endocrinol Metab 2003; 88: 4731-9.
- 11. Garmey, E G, Liu, Q, Sklar, C A, et al., Longitudinal
changes in obesity and body mass index among adult
survivors of childhood acute lymphoblastic leukemia:
a report from the Childhood Cancer Survivor Study. J
Clin Oncol 2008; 26: 4639-45.
- 12. Breene, R A, Williams, R M, Hartle, J, et al., Auxological
changes in UK survivors of childhood acute lymphoblastic
leukaemia treated without cranial irradiation.
Br J Cancer 2011; 104: 746-9.