ESPE Abstracts

Endocrine complications are common among children who have finished their cancer treatment. Approximately half of those children will experience at least one hormonal disorder. The risk of endocrine deficiency is related to the child's gender and age, tumor location and therapies used (surgery, chemotherapy or radiation therapy).

Aim of the study: To address the main endocrine abnormalities following cancer therapies that occurs later in children for early recognition of long-term endocrinal disturbances.

Patients and method: This cross sectional study conducted on seventy children who completed their cancer treatment successfully. All data related to age, type of cancer (leukemia, lymphoma or solid tumor), date of diagnosis, lines of treatment (chemotherapy, radiotherapy, and surgery), duration of cancer treatment, and duration since finishing treatment (follow up duration) has been collected. Physical examination included anthropometric measurements (Z-score for weight, height, and BMI) and Tanner staging for all children. Laboratory detection of endocrine abnormalities included TSH, free T4, HbA1c, and if affected, oral glucose tolerance test was done. FSH, LH, testosterone or estrogen for cases of delayed puberty has been done. GH provocation test for cases of growth failure (Z-score <-2) has been done.

Results: This study was done on 70 children (males constitutes 54.3%) who finished their cancer treatment with mean age (11.18±3.88 y). Their median duration for treatment was 1.37y ranging from (0.5y-12y) and follow up duration ranging from (0.5y-10y). Pubertal assessment by Tanner staging showed that 52.9% of studied children were in the prepubertal period. About 32.9% of studied group were treated from leukemia, 22.9% were treated from HL, 10% from NHL, Brain tumors were 7.1% and other tumors (such as rhabdomyosarcoma, Wilms tumor) were 27.1%. Out of our studied group, 21.4% showed endocrinal problems. Hypothyroidism constitute 5.7%, prediabetes was 5.7%. Growth retardation constituted 8.6% with 4.3% of them was due to growth hormone deficiency and 1.4% was found to have combined hypothyroidism and prediabetes. There is statistically significant correlation between Exposure to neck radiation and developing hypothyroidism. Sixty% of cases having diabetes predisposition were treated from HL and 40% were treated from leukemia (associated with chronic steroid use) with no significant data among NHL, brain and other tumor.

Conclusion: Long-term follow-up is crucial since endocrine side effects from cancer treatments may persist for years after they are finished.