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DOI: 10.1055/s-0044-1792004
Early Endocrine and Metabolic Complications in Childhood Cancer Survivors—Experience from a Tertiary Care Pediatric Oncology Center in South India
Funding The study conforms to the Declaration of Helsinki.
Abstract
Background Endocrine abnormalities and metabolic complications remain one of the common late effects after cancer therapy in children. Data on the incidence and pattern of complications would help to guide appropriate monitoring and treatment of childhood cancer survivors.
Methods, Aims, and Objectives Purpose of study is to determine endocrine and metabolic effects in childhood cancer survivors including both hematological malignancies and solid tumors due to cancer per se and treatment-related, including different chemotherapeutic agents and radiotherapy.
Results Among 97 participants, 84 children (84.5%) had at least one endocrine or metabolic complication; 41 children (42.3%) had more than two endocrine/metabolic complications. Common endocrine complications included precocious puberty (6.2%), short stature (6.2%), and hypothyroidism (5.1%). Among metabolic complications, dyslipidemia was the highest with an incidence of 68%, followed by fasting hyperinsulinism (32%), diastolic hypertension (18.6%), systolic hypertension (11.3%), obesity (8.8%), and metabolic syndrome (8.2%) and impaired fasting glucose (4.1%).
Among endocrine complications, there was a significant increase in incidence of hypothyroidism among children receiving radiotherapy (odds ratio [OR]: 7.13, 95% confidence interval [CI]: 1.1–46.2), and among metabolic complications, a significant increase in incidence of metabolic syndrome in children treated with L-asparaginase compared with those not treated with L-asparaginase was observed (OR: 5.61, 95% CI: 1.07–29.5). There was no significant difference between incidence of observed endocrine and metabolic complications based on type of tumor, gender, and puberty status of study participants.
Conclusion This study suggests that there is significant incidence of endocrine and metabolic complications in childhood cancer survivors, hence timely and appropriate recognition of these complications by appropriate screening recommendations and pursuing further endocrine evaluation rationally is needed.
Ethical Approval
Ethical approval was obtained from the institutional research ethics committee of Sri Ramachandra Institute of Higher Education and Research (Ref. no. CSP-MED/15/AUG/24/46).
Author's Contribution
S.T.T., D.S., D.J., and D.L.J. worked on the data analysis and wrote the initial draft; D.L.J., D.S., and L.M. contributed to the manuscript data and editing the draft; D.J. revised it for clinical content, and final revision for intellectual content by D.J. and J.X.S. All the other authors were involved in the management of the child. All authors read and approved the final manuscript.
Publication History
Received: 06 May 2024
Accepted: 21 September 2024
Article published online:
06 November 2024
© 2024. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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