Table 2
Endocrine complications and therapy-related risk factors
| System | Complication | Therapy-related risks |
|---|---|---|
| Linear growth | Skeletal dysplasia | Radiotherapy to the spine. Younger the age and higher the dose, greater the risk |
| GH deficiency | Surgery | |
| Cranial radiotherapy | ||
| Puberty | Precocious puberty | Cranial radiotherapy |
| Hypogonadotropic hypogonadism | Cranial radiotherapy | |
| Testes | Leydig cell dysfunction | Alkylating agents |
| Radiotherapy to the testes | ||
| Germ cell dysfunction | Alkylating agents | |
| Radiotherapy to the testes | ||
| Ovaries | Acute ovarian failure | Alkylating agents |
| Radiotherapy to the ovaries | ||
| Premature menopause | Alkylating agents | |
| Radiotherapy to the ovaries | ||
| Adrenals | ACTH deficiency | Direct insult (surgery, tumoral expansion) |
| Cranial radiotherapy | ||
| Glucocorticoids (transient) | ||
| Thyroid | TSH deficiency | Cranial radiotherapy |
| Primary hypothyroidism | Radiotherapy (local or scatter) | |
| TBI | ||
| 131I-MIBG and 131I-labeled monoclonal antibody | ||
| Cranial radiotherapy | ||
| Primary hyperthyroidism | Radiotherapy (local or scatter) | |
| Autoimmune disease | HSCT | |
| Neoplasms | Radiotherapy (local or scatter) | |
| Bone | Osteoporosis | Methotrexate |
| Glucocorticoids | ||
| Metabolism | Obesity | Cranial radiotherapy |
| Glucocorticoids | ||
| Surgery | ||
| Diabetes mellitus | Alkylating agents | |
| TBI and abdominal irradiation |
-
131I-MIBG, iodine-131-metaiodobenzylguanidine; HSCT, hematopoietic stem cell transplantation.












