Representative tumor, location | Therapy | Highest endocrine risk |
Hodgkin lymphoma | Chemotherapy, mantle irradiation | Primary hypothyroidism, primary hypogonadism |
Rhabdomyosarcoma or neuroblastoma, pelvis | Excision, chemotherapy, focal radiation | Primary gonadal failure |
ALL | Chemotherapy and 18 Gy cranial radiation | Growth hormone deficiency (GHD), early-onset puberty, rapid tempo of puberty, osteoporosis |
AML | Chemotherapy to achieve remission, bone marrow transplant (12 Gy total body radiation) | Primary hypothyroidism, primary hypogonadism, reduced epiphyseal growth (direct effect of radiation), GHD, central hypothyroidism |
Medulloblastoma, posterior fossa | Surgical excision, chemotherapy, craniospinal irradiation, and posterior fossa "boost" to 50 Gy | Reduced spinal growth, central or primary or mixed hypothyroidism, GHD, precocious puberty and/or gonadotropin deficiency, ACTH deficiency |
Craniopharyngioma, suprasellar | Biopsy, excision and focal radiation 30 to 50 Gy | Panhypopituitarism, diabetes insipidus, precocious puberty or gonadotropin deficiency |
Rhabdomyosarcoma, nasopharyngeal | Excision, focal radiation 30 to 50 Gy, and chemotherapy | Panhypopituitarism, central or primary or mixed hypothyroidism |
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