Table of Contents

HK J Paediatr (New Series)
Vol 24. No. 4, 2019

HK J Paediatr (New Series) 2019;24:192-202

Original Article

Long-term Therapy Related Side Effect on Endocrine System Among Paediatric Survivors with Brain Tumour and Acute Lymphoblastic Leukaemia

SSW Chan, JYL Tung, DKL Cheuk, WHS Wong, GCF Chan


Purpose: Treatments for childhood acute lymphoblastic leukaemia (ALL) and brain tumours could cause endocrine sequelae after completion of treatment. Yet, the local incidence and pattern are not known. This study aims to evaluate the frequency and nature of endocrine complications among Hong Kong Chinese childhood brain tumours and ALL survivors. Methods: It is a retrospective cross-sectional review on paediatric ALL and brain tumour patients treated in a tertiary hospital from January 2000 to August 2015. Children survived for more than 2 years were included. Findings: Overall 233 patients were included in the study (ALL=138; brain tumours=95). The mean duration of follow-up was 10.3 years. Seventy-eight patients (33.5%) had at least one endocrine complication, and 57 (25.4%) had more than one endocrine complication. Hypothyroidism (n=45) was the commonest complication, followed by hypogonadism (n=40). Cranial radiotherapy was a major risk factor of endocrinopathy. Conclusions: Radiotherapy appeared to be the most significant risk factor. Updated regular surveillance program, together with proper patients' educations are mandatory.

目的:兒童急性淋巴細胞白血病(ALL)和腦腫瘤的治療可引起病童治療後出現內分泌病症。然而,本地有關病童的發病率和模式的資料缺乏。本研究目的為評估香港華裔兒童腦腫瘤和ALL出現存活者的內分泌併發症的發生率和狀態。方法:對2000年1月至2015年8月期間一線醫院治療的ALL和腦腫瘤病人進行回顧性橫斷面分析。研究對象包括病後存活超過2年的兒童。結果:總共233例病人獲納入研究(ALL 138例,腦腫瘤95例)。平均追蹤時間為10.3年。38例病人(33.5%)患有至少1種內分泌併發症,57例(25.4%)患有一種以上。甲狀腺功能低下(n=45)為最常見併發症,隨後是性腺功能低下(n=40)。顱腦放射治療是內分泌異常的主要風險因素。結論:研究發現放射治療為最重要的風險因素,醫療單位必須定期更新常規監控計劃,並配合適當的病人教育。

Keyword : ALL; Brain tumours; Childhood cancers; Endocrine complications



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