ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet12786ometendo-12786Research ArticleНаучные обзорыReviewsДефицит гормона роста у лиц, перенесших химиолучевую терапию злокачественных опухолей головного мозга и острого лимфобластного лейкоза в детствеGrowth hormone deficiency in childhood brain tumors and acute lymphoblastic leukemia survivorshttps://orcid.org/0000-0001-6073-328XПавловаМ. Г.PavlovaM. G.

Павлова Мария Геннадиевна - кандидат медицинских наук; eLibrary SPIN: 2205-1288.

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Maria G. Pavlova - MD, PhD; eLibrary SPIN: 2205-1288

8-2 Trubetskaya street, 119991 Moscow

mgp.med@gmail.comhttps://orcid.org/0000-0003-4262-2724ЦеловальниковаТ. Ю.TselovalnikovaT. Y.

Целовальникова Татьяна Юрьевна, кандидат медицинских наук; eLibrary SPIN: 2688-6494

Tatiana Y. Tselovalnikova - MD, PhD; eLibrary SPIN: 2688-6494

t.tselovalnikova@gmail.comhttps://orcid.org/0000-0002-4704-8453ЮдинаА. Е.YudinaA. E.

Юдина Алла Евгеньевна - кандидат медицинских наук; eLibrary SPIN: 9307-7889

Alla E. Yudina - MD, PhD; eLibrary SPIN: 9307-7889

alla1301@yandex.ruhttps://orcid.org/0000-0003-2320-1051ГолоунинаО. О.GolouninaO. O.

Голоунина Ольга Олеговна - студентка; eLibrary SPIN: 7793-2123

Olga O. Golounina - student; eLibrary SPIN: 7793-2123

olga.golounina@mail.ruhttps://orcid.org/0000-0003-3494-8011ЗиловА. В.ZilovA. V.

Зилов Алексей Вадимович - кандидат медицинских наук; eLibrary SPIN: 8575-1247

Alexey V. Zilov - MD, PhD; eLibrary SPIN: 8575-1247

avzilov@hotmail.comhttps://orcid.org/0000-0002-0428-0498МазеркинаН. А.MazerkinaN. A.

Мазеркина Надежда Александровна, доктор медицинских наук; eLibrary SPIN:1012-2923

Nadezhda A. Mazerkina - MD, PhD; eLibrary SPIN:1012-2923.

Moscow

nmazer@nsi.ruhttps://orcid.org/0000-0002-8607-3635ЖелудковаО. Г.ZheludkovaO. G.

Желудкова Ольга Григорьевна - доктор медицинских наук, профессор; eLibrary SPIN: 4850-7788.

Москва

Olga G. Zheludkova - MD, PhD, Professor; eLibrary SPIN: 4850-7788.

Moscow

clelud@mail.ruhttps://orcid.org/0000-0002-3026-6315ФадеевВ. В.FadeevV. V.

Фадеев Валентин Викторович - доктор медицинских наук, профессор, член-корр. РАН; eLibrary SPIN: 6825-8417

Москва

Valentin V. Fadeyev - MD, PhD, Professor; eLibrary SPIN: 6825-8417.

Moscow

walfad@mail.ruПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationНациональный медицинский исследовательский центр нейрохирургии им. академика Н.Н. БурденкоРоссияN.N. Burdenko national medical research center of neurosurgeryRussian FederationНаучно-практический центр специализированной медицинской помощи детям им. В.Ф. Войно-ЯсенецкогоРоссияVoino-Yasenetsky Krasnoyarsk State Medical UniversityRussian Federation202119022022184484495Copyright © Павлова М.Г., Целовальникова Т.Ю., Юдина А.Е., Голоунина О.О., Зилов А.В., Мазеркина Н.А., Желудкова О.Г., Фадеев В.В., 20222022Павлова М.Г., Целовальникова Т.Ю., Юдина А.Е., Голоунина О.О., Зилов А.В., Мазеркина Н.А., Желудкова О.Г., Фадеев В.В.Pavlova M.G., Tselovalnikova T.Y., Yudina A.E., Golounina O.O., Zilov A.V., Mazerkina N.A., Zheludkova O.G., Fadeev V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/12786

Благодаря внедрению в клиническую практику новых методов диагностики и стандартизированных протоколов лечения число пациентов, перенесших в детстве онкологическое заболевание и успешно преодолевших барьер пятилетней выживаемости, увеличивается с каждым годом. Противоопухолевая терапия неизбежно сопровождается развитием тяжелых отдаленных последствий, в том числе со стороны эндокринной системы, среди которых недостаточность гормона роста встречается чаще других. Низкий конечный рост затрудняет психологическую и социальную адаптацию пациентов, снижает качество их жизни. Влияние заместительной терапии препаратами гормона роста на физиологические процессы и состояние здоровья в целом вызывает большой интерес исследователей. В ряде работ продемонстрировано потенцирующее воздействие гормона роста и инсулиноподобного фактора роста-1 на рост и пролиферацию клеток. В этой связи вопрос об увеличении риска рецидива заболевания или развития вторичных опухолей у пациентов, перенесших онкологическое заболевание, вызывает много споров и является предметом непрерывного изучения. В настоящем обзоре обобщены имеющиеся в литературе данные о патогенезе и распространенности дефицита гормона роста, развивающегося после химиолучевой терапии злокачественных новообразований в детстве, в частности после лечения опухолей головного мозга и острого лимфобластного лейкоза. Обсуждаются имеющиеся проблемы диагностики дефицита гормона роста, безопасность заместительной терапии дефицита гормона роста у детей и взрослых.

Thanks to modern treatment protocols, childhood cancer survivors (CCS) are a very fast-growing population nowadays. Cancer therapy inevitably leads to different late adverse effects, where endocrine disorders are highly prevalent, including growth hormone deficiency (GHD) which is the most common endocrine outcome after cancer treatment in childhood and contributes to impaired growth. Short stature is a big issue, which leads to problems in psychological and social adaptation of patients and reduces their quality of life. Impact of GH treatment on various physiological processes and global outcome of CCS is of great interest. Several studies have demonstrated an influence of GH and IGF-1 on the development/tumour growth, cell proliferation. In this regard, the issue of increasing the risk of cancer recurrence and/or the development of secondary neoplasms in CCS, causes a lot of controversy and is the subject of continuous evaluation. In this review, we went through the available data on the prevalence and pathogenesis of GHD following chemo- and radiotherapy, in particular after treatment of brain tumors and acute lymphoblastic leukaemia in childhood. In addition, here we discuss the existing problems in the diagnosis of GHD, the safety of GH replacement therapy, as well as the treatment algorithm of the GHD in adults.

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The authors declare that there are no conflicts of interest present.