Hypothalamic-Pituitary and Other Endocrine Surveillance Among Childhood Cancer Survivors.

IF 22 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Laura van Iersel, Renee L Mulder, Christian Denzer, Laurie E Cohen, Helen A Spoudeas, Lillian R Meacham, Elaine Sugden, Antoinette Y N Schouten-van Meeteren, Eelco W Hoving, Roger J Packer, Gregory T Armstrong, Sogol Mostoufi-Moab, Aline M Stades, Dannis van Vuurden, Geert O Janssens, Cécile Thomas-Teinturier, Robert D Murray, Natascia Di Iorgi, Sebastian J C M M Neggers, Joel Thompson, Andrew A Toogood, Helena Gleeson, Cecilia Follin, Edit Bardi, Lilibeth Torno, Briana Patterson, Vera Morsellino, Grit Sommer, Sarah C Clement, Deokumar Srivastava, Cecilie E Kiserud, Alberto Fernandez, Katrin Scheinemann, Sripriya Raman, Kevin C J Yuen, W Hamish Wallace, Louis S Constine, Roderick Skinner, Melissa M Hudson, Leontien C M Kremer, Wassim Chemaitilly, Hanneke M van Santen
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引用次数: 13

Abstract

Endocrine disorders in survivors of childhood, adolescent, and young adult (CAYA) cancers are associated with substantial adverse physical and psychosocial effects. To improve appropriate and timely endocrine screening and referral to a specialist, the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) aims to develop evidence and expert consensus-based guidelines for healthcare providers that harmonize recommendations for surveillance of endocrine disorders in CAYA cancer survivors. Existing IGHG surveillance recommendations for premature ovarian insufficiency, gonadotoxicity in males, fertility preservation, and thyroid cancer are summarized. For hypothalamic-pituitary (HP) dysfunction, new surveillance recommendations were formulated by a guideline panel consisting of 42 interdisciplinary international experts. A systematic literature search was performed in MEDLINE (through PubMed) for clinically relevant questions concerning HP dysfunction. Literature was screened for eligibility. Recommendations were formulated by drawing conclusions from quality assessment of all evidence, considering the potential benefits of early detection and appropriate management. Healthcare providers should be aware that CAYA cancer survivors have an increased risk for endocrine disorders, including HP dysfunction. Regular surveillance with clinical history, anthropomorphic measures, physical examination, and laboratory measurements is recommended in at-risk survivors. When endocrine disorders are suspected, healthcare providers should proceed with timely referrals to specialized services. These international evidence-based recommendations for surveillance of endocrine disorders in CAYA cancer survivors inform healthcare providers and highlight the need for long-term endocrine follow-up care in subgroups of survivors and elucidate opportunities for further research.

儿童癌症幸存者的下丘脑-垂体和其他内分泌监测。
儿童、青少年和青年(CAYA)癌症幸存者的内分泌紊乱与严重的不良身体和心理社会影响相关。为了改善适当和及时的内分泌筛查和专家转诊,国际儿童癌症晚期影响指南协调小组(IGHG)旨在为医疗保健提供者制定基于证据和专家共识的指南,以协调CAYA癌症幸存者内分泌疾病监测的建议。现有的IGHG监测建议对卵巢早衰、男性性腺毒性、生育能力保存和甲状腺癌进行总结。对于下丘脑-垂体(HP)功能障碍,由42名跨学科国际专家组成的指导小组制定了新的监测建议。在MEDLINE(通过PubMed)进行了系统的文献检索,以了解与HP功能障碍有关的临床相关问题。对文献进行了合格筛选。根据对所有证据的质量评估得出结论,并考虑到早期发现和适当管理的潜在益处,制定了建议。医疗保健提供者应该意识到,CAYA癌症幸存者有内分泌失调的风险增加,包括HP功能障碍。建议对高危幸存者进行定期监测,包括临床病史、拟人测量、体格检查和实验室测量。当怀疑内分泌紊乱时,医疗保健提供者应及时转诊到专门服务机构。这些针对CAYA癌症幸存者内分泌紊乱监测的国际循证建议为医疗保健提供者提供了信息,并强调了对幸存者亚组进行长期内分泌随访护理的必要性,并阐明了进一步研究的机会。
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来源期刊
Endocrine reviews
Endocrine reviews 医学-内分泌学与代谢
CiteScore
42.00
自引率
1.00%
发文量
29
期刊介绍: Endocrine Reviews, published bimonthly, features concise timely reviews updating key mechanistic and clinical concepts, alongside comprehensive, authoritative articles covering both experimental and clinical endocrinology themes. The journal considers topics informing clinical practice based on emerging and established evidence from clinical research. It also reviews advances in endocrine science stemming from studies in cell biology, immunology, pharmacology, genetics, molecular biology, neuroscience, reproductive medicine, and pediatric endocrinology.
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