Endocrine and XXXX among adult survivors of childhood @entity1313 : @entity5 Survivor Study.

@entity1 @entity1375 @entity2338 @entity64 @entity12707 @entity137 @entity1313 @entity5 @entity170 @entity951 @entity4461 @entity65
BACKGROUND: Survivors of childhood @entity1313 (CBTs) are at high risk for a variety of late adverse effects. Most research on long-term effects of CBTs has been comprised of single-institution case series without comparison groups. Research on @entity12707 late effects often is focused on neurologic and sensory outcomes, with less emphasis on other potential targets such as the endocrine and circulatory systems. The current study was conducted to contrast the incidence of endocrine and @entity65 among @entity12707 survivors as a function of treatment and to determine the risk of occurrence of these conditions relative to a sibling comparison group. METHODS: As part of the @entity5 Survivor Study (CCSS), treatment data were collected from medical records and self-reported late effects were ascertained from a survey questionnaire of 1,607 @entity12707 @entity1 who survived their disease for 5 or more years. For comparison purposes, questionnaire data were also collected from 3418 randomly selected siblings of @entity1 in CCSS. RESULTS: One or more endocrine conditions were reported by 43% of @entity12707 survivors. Compared with siblings, @entity12707 survivors had a significantly increased risk of late-onset (>/= 5 years postdiagnosis) @entity1375 (relative risk [RR] = 14.3; 95% confidence interval [95% CI] 9.7-21.0), @entity2338 (RR = 277.8; 95% CI 111.1-694.9), the need for medications to induce puberty (RR = 86.1; 95% CI 31.1-238.2), and @entity170 (RR = 24.7; 95% CI 9.9-61.4). One or more @entity65 were reported by 18% of @entity12707 survivors, with an elevated late-onset risk for @entity64 (RR = 42.8; 95% CI 16.7-109.8), @entity4461 (RR = 5.7; 95% CI 3.2-10.0), and @entity951 -like symptoms (RR = 2.0; 95% CI 1.5-2.7). Very few late effects were evident among those treated with surgery only, but risks were consistently elevated for those treated with radiation and surgery, and higher still for those who also received adjuvant chemotherapy. CONCLUSIONS: Childhood brain @entity5 survivors are at a significantly increased risk for several adverse endocrine and @entity65 , particularly if they were treated with radiation and chemotherapy. Lifetime medical surveillance and follow-up for potential @entity137 are necessary because treatment-related complications may occur many years after therapy.
