Hypothalamic-Pituitary and Other Endocrine Surveillance Among Childhood Cancer Survivors

Author:

van Iersel Laura1ORCID,Mulder Renee L2,Denzer Christian3,Cohen Laurie E456,Spoudeas Helen A789,Meacham Lillian R1011ORCID,Sugden Elaine12,Schouten-van Meeteren Antoinette Y N2,Hoving Eelco W2,Packer Roger J13ORCID,Armstrong Gregory T14,Mostoufi-Moab Sogol15,Stades Aline M16,van Vuurden Dannis2,Janssens Geert O217,Thomas-Teinturier Cécile1819,Murray Robert D2021,Di Iorgi Natascia22ORCID,Neggers Sebastian J C M M23,Thompson Joel24,Toogood Andrew A25,Gleeson Helena25,Follin Cecilia26,Bardi Edit2728,Torno Lilibeth29,Patterson Briana1011,Morsellino Vera30,Sommer Grit3132,Clement Sarah C33,Srivastava Deokumar34,Kiserud Cecilie E35,Fernandez Alberto36,Scheinemann Katrin373839,Raman Sripriya40,Yuen Kevin C J41,Wallace W Hamish42,Constine Louis S43,Skinner Roderick44,Hudson Melissa M45,Kremer Leontien C M246,Chemaitilly Wassim47,van Santen Hanneke M1ORCID

Affiliation:

1. Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands

2. Princess Máxima Center for Pediatric Oncology, Department of Neuro-oncology, Utrecht, The Netherlands

3. Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics & Adolescent Medicine, Ulm University Medical Center, Ulm, Germany

4. Division of Endocrinology, Boston Children’s Hospital, Boston, MA, USA

5. Dana Farber/Boston Children’s Cancer and Blood Disorder Center, Boston, MA, USA

6. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

7. The London Centre for Pediatric Endocrinology & Diabetes, London, UK

8. Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK

9. The London Centre for Pediatric Endocrinology and Diabetes, University College London Hospital, London, UK

10. Emory University School of Medicine;  Atlanta, GA,  USA

11. Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta, Atlanta, GA,  USA

12. Department of Clinical Oncology, Oxford, UK

13. The Brain Tumor Institute, Center for Neuroscience and Behavioral Medicine, Children’s National Health System, Washington, DC, USA

14. Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis TN, USA

15. Department of Pediatrics, The Children’s Hospital of Philadelphia, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA,  USA

16. Department of Endocrinology, University Medical Center  Utrecht, Utrecht, The Netherlands

17. Department of Radiation Oncology, University Medical Center  Utrecht, Utrecht, The Netherlands

18. Radiation Epidemiology Group, Center for Research in Epidemiology and Population Health (CESP), Université Paris-Sud XI, Villejuif, France

19. Department of Pediatric Endocrinology, APHP, Hôpitaux Paris-Sud, Site Bicetre, Le Kremlin-Bicetre, France

20. Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

21. Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK

22. Department of Pediatrics, Istituto Giannina Gaslini, University of Genova, Genova, Italy

23. Department of Internal Medicine, Endocrinology Section, Pituitary Center Rotterdam, Erasmus University Medical Center, Rotterdam, The Netherlands

24. Division of Hematology/Oncology/BMT, Children’s Mercy Hospitals and Clinics, Kansas City, Missouri, USA

25. Department of Endocrinology, Queen Elizabeth Hospital Birmingham, Birmingham, UK

26. Department of Oncology, Skåne University Hospital, Lund, Sweden

27. Department of Pediatrics and Adolescent Medicine, Kepler Universitätsklinikum, Linz, Austria

28. St Anna Childrens Hospital, Vienna, Austria

29. Division of Pediatric Oncology, CHOC Children’s Hospital/University of California, Orange, CA, USA

30. DOPO Clinic, Division of Pediatric Hematology/Oncology, IRCCS Istituto Giannina Gaslini, Genova, Italy

31. Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland

32. Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Bern University Hospital, University of Bern, Switzerland

33. Department of Pediatrics, Amsterdam University Medical Center, location VU University Medical Center, Amsterdam, The Netherlands

34. Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis TN, USA

35. Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway

36. Endocrinology Department, Hospital Universitario de Mostoles, Madrid, Spain

37. Division of Pediatric Hematology/Oncology, Department of Pediatrics, Kantonsspital Aarau, Aarau, Switzerland

38. Division of Pediatric Hematology/Oncology, University Children’s Hospital Basel and University of Basel, Basel, Switzerland

39. Division of Pediatric Hematology/Oncology, McMaster Children’s Hospital and McMaster University, Hamilton, ON, Canada

40. Division of Pediatric Endocrinology and Diabetes, Children’s Hospital of Pittsburgh, Pittsburgh, PA,  USA

41. Department of Neuroendocrinology and Neurosurgery, Barrow Pituitary Center, Barrow Neurological Institute, University of Arizona College of Medicine, Phoenix, AZ, USA

42. Department of Paediatric Oncology, Royal Hospital for Sick Children, Edinburgh, UK

43. Departments of Radiation Oncology and Pediatrics, University of Rochester Medical Center, Rochester, NY, USA

44. Department of Paediatric and Adolescent Haematology/Oncology, Great North Children’s Hospital and Newcastle University Centre for Cancer, Newcastle upon Tyne, UK

45. Department of Epidemiology and Cancer Control, and Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA

46. Department of Pediatric Oncology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

47. Division of Endocrinology and Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA

Abstract

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.

Publisher

The Endocrine Society

Subject

Endocrinology,Endocrinology, Diabetes and Metabolism

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