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.