Endocrine complications of childhood cancer therapy: evaluation and management.

Endocrine complications of cancer therapy are reported in over 40% of childhood cancer survivors. As survival rates for childhood cancers continue to improve, both the incidence and prevalence of endocrinopathies directly related to cancer therapy will increase. To appropriately screen for and treat endocrinopathies in cancer survivors, pediatric endocrinologists must be aware of the differential pattern and severity of endocrine disturbances associated with both chemotherapy and radiation. Determining an individual child's risk for developing endocrine abnormalities requires a thorough analysis of the child's chemotherapeutic regimen, radiation dose, fractionation of radiotherapy, age during therapy, pubertal status during therapy and length of time since completion of therapy. The following review will identify endocrinopathies associated with different chemotherapy and radiation protocols and will review lifelong screening and treatment strategies for endocrine complications of childhood cancer.