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Related Experiment Videos

Hypothalamic dysfunction after chemotherapy.

Susan R Rose1, Randi E Schreiber, Nicole S Kearney

  • 1Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA. susan.rose@cchmc.org

Journal of Pediatric Endocrinology & Metabolism : JPEM
|February 13, 2004
PubMed
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Chemotherapy alone can cause hormonal deficiencies in childhood cancer survivors, affecting growth and puberty. Regular monitoring for growth and pubertal development is crucial, even without cranial irradiation.

Area of Science:

  • Pediatric Oncology
  • Endocrinology
  • Cancer Survivorship

Background:

  • Cranial irradiation is a known cause of hypothalamic-pituitary dysfunction in pediatric cancer patients.
  • The impact of chemotherapy alone on hormonal function in these patients is less understood.
  • Previous assumptions suggested chemotherapy without cranial irradiation does not lead to hormonal deficiencies.

Purpose of the Study:

  • To determine if chemotherapy without cranial irradiation can cause hormonal deficiencies in childhood cancer survivors.
  • To evaluate the incidence of hypothalamic-pituitary dysfunction in patients treated with chemotherapy only.
  • To assess the types of hormonal deficits observed in this patient group.

Main Methods:

  • Retrospective review of medical records of 362 childhood cancer patients.

Related Experiment Videos

  • Focus on 31 patients who received chemotherapy but no cranial or total body irradiation and had no central nervous system tumors.
  • Full hypothalamic-pituitary evaluation for altered growth and development.

    • Main Results:

    • High rates of hormonal deficiencies were observed: 48% growth hormone deficiency (GHD), 52% central hypothyroidism (TSH-D).
    • Pubertal abnormalities occurred in 32%, including precocious puberty and gonadal failure.
    • 81% of patients exhibited GHD, TSH-D, precocious puberty, and/or gonadotropin deficiency.

    Conclusions:

    • Chemotherapy alone, without cranial irradiation, can lead to significant hypothalamic dysfunction in pediatric cancer survivors.
    • Annual monitoring of growth and pubertal development is recommended for all pediatric cancer survivors.
    • Evaluation for GHD, TSH-D, and other hypothalamic issues is essential for poorly growing survivors, irrespective of cranial irradiation status.