Metabolic/endocrine disorders in survivors of childhood-onset and cranial radiotherapy- treated ALL/NHL: a meta-analysis.
Reprod Biol Endocrinol
; 21(1): 91, 2023 Oct 04.
Article
in En
| MEDLINE
| ID: mdl-37794442
ABSTRACT
BACKGROUND:
Cranial radiotherapy (CRT) is recommended to high-risk pediatric patients with acute lymphoblastic leukemia or aggressive non-Hodgkin's lymphoma (ALL/NHL). However, effects of CRT treatment on the development of metabolic/endocrine disorders remain unclear. This meta-analysis aimed to identify metabolic and endocrine disturbances in survivors of childhood-onset and CRT-treated ALL/NHL.METHODS:
Different online databases were searched using restricted search fields. Follow-up data and outcome measurements, including the prevalence of growth hormone (GH) deficiency, hypothyroidism, vitamin D deficiency, overweight/obesity, and hypogonadism were recorded. The height data was indicated by height-standard deviation score (height-SDS). Statistical estimates such as odds ratio (OR) and weighted standard mean difference (SMD) were compared between additional CRT treatment group and non-CRT treatment group. Study-to-study heterogeneity was calculated by calculating I-squared statistic, and fixed/random effect was applied to synthesize and analyze extracted data.RESULTS:
Fifteen studies were included (4269 patients in total). Adult height SDS was lower in CRT-treated patients (pooled SMD = -0.581, 95% CI -0.649--0.512), and CRT-treated patients were likely to develop short stature (pooled OR = 2.289, 95% CI1.674-3.130). Regardless of the study year, which potentially reflects the state-of-the-art CRT technique, the prevalence of short stature and GH deficiency was time-independent. Additionally, previous CRT can increase the risk of precocious puberty (pooled OR = 2.937, 95% CI 1.281-6.736), hypothyroidism (pooled OR = 2.057, 95% CI1.510-2.801), and hypogonadism (pooled OR = 3.098, 95% CI2.521-3.807). However, the risk of being overweight/obese was similar between the patients with and without CRT (pooled OR = 1.278, 95% CI 0.675-2.421).CONCLUSION:
Childhood-onset and CRT-treated ALL/NHL survivors are likely to have shorter height, precocious puberty, hypothyroidism, and hypogonadism.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Puberty, Precocious
/
Endocrine System Diseases
/
Hypogonadism
/
Hypothyroidism
/
Metabolic Diseases
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limits:
Adult
/
Child
/
Humans
Language:
En
Journal:
Reprod Biol Endocrinol
Journal subject:
ENDOCRINOLOGIA
/
MEDICINA REPRODUTIVA
Year:
2023
Type:
Article
Affiliation country:
China