Adverse effect of therapy and late sequelae in survivors

摘要: At least four factors may contribute to the diminished height achieved in adulthood by children having undergone craniospinal irradiation: i) growth hormone (GH) deficiency, ii) induction of precocious puberty [1,2,51], iii) effects on plate bone [51], and possibly iv) dysfunction testis or ovary thyroid gland when these are irradiated (see section Hypothalamic-pituitary Function Their management). Shalet et al. estimated reduction due whole spinal irradiation be 9,7 5.5 cm at age 1, 5 10 years, respectively [59]. If replacement gonadotropin releasing analog therapies successful, can maintain legs patients with puberty. Nevertheless, still have a short sitting spine after [6,30]. treatment for CNS GCT does not involve irradiation, adult radiotherapy depends GH deficiency puberty, specifically, peak which pubertal development occurs [2]. Effect chemotherapy has been reported negligible [2], but combination induces more delay than alone [45].