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Significant metabolic and endocrine disturbances have been found in survivors of childhood-onset acute lymphoblastic leukemia or aggressive non-Hodgkin’s lymphoma treated with cranial radiotherapy. A recent meta-analysis emphasizes monitoring for potential long-term complications in these patients.

  • Childhood-onset and cranial radiotherapy-treated acute lymphoblastic leukemia or aggressive non-Hodgkin’s lymphoma survivors are more likely to have reduced height, precocious puberty, hypothyroidism, and hypogonadism.
  • The effects of cranial radiotherapy on metabolic and endocrine disorders remain a concern.
  • The risk of being overweight or obese is similar between cranial radiotherapy-treated and non-cranial radiotherapy-treated patients.

Cranial radiotherapy (CRT) plays an important role in treating high-risk pediatric patients with acute lymphoblastic leukemia or aggressive non-Hodgkin’s lymphoma (ALL/NHL). However, its long-term impact on metabolic and endocrine health remains a subject of ongoing investigation. 

A comprehensive meta-analysis published in Reproductive Biology and Endocrinology sought to determine the potential side effects of CRT on survivors of childhood-onset ALL/NHL.

Endocrine and Metabolic Disturbances Post-Cranial Radiotherapy 

The study found that survivors treated with CRT during childhood tended to experience precocious puberty, with a significant likelihood of developing short stature, hypothyroidism, and hypogonadism. Short stature remained a consistent finding regardless of the study year. 

Obesity Risk: A Silver Lining? 

The impact of CRT on weight has been somewhat unclear. Research indicates that there isn’t a significant difference in the likelihood of becoming overweight or obese between individuals who have received CRT and those who haven’t. This implies that despite CRT causing certain hormonal changes, its influence on weight could be offset by various other elements, such as personal lifestyle decisions and inherent genetic factors.

Insight for Clinicians 

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For healthcare providers, these findings suggest the importance of a comprehensive monitoring strategy for pediatric ALL/NHL survivors treated with CRT. By monitoring for signs of endocrine and metabolic disturbances, clinicians can provide timely treatments and improve the long-term health outcomes for these patients. In addition, as endocrine disturbances could arise years after the completion of CRT, a long-term follow-up is crucial to ensure that potential problems are identified and managed proactively.


Zhang, D., & Gu, M. (2023). Metabolic/endocrine disorders in survivors of childhood-onset and cranial radiotherapy- treated ALL/NHL: a meta-analysis. Reproductive Biology and Endocrinology, 21(1). https://doi.org/10.1186/s12958-023-01137-y