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Changes in body composition after childhood cancer treatment: impact on future health status--a review.

Brouwer CA, Gietema JA, Kamps WA, de Vries EG, Postma A

Department of Paediatrics, Subdivision Paediatric Oncology, University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands. c.a.j.brouer@bkk.umcg.nl

PURPOSE: To describe data on changes in body composition in childhood cancer survivors. Underlying mechanisms in development of obesity are addressed, in order to discuss intervention strategies. METHODS: A systematic literature search was undertaken with a number of search terms. RESULTS: Female survivors of ALL and brain tumours, especially if treated with cranial irradiation, showed a higher prevalence of obesity compared with the general population, while survivors of other malignancies had a higher prevalence of underweight. Influences of corticosteroid treatment and cytostatics on body composition are uncertain. Diminished physical activity, early adiposity rebound (<5 years of age) and/or hypothalamic involvement of tumour or treatment, and subsequent growth hormone deficiency, may play a role in the development of obesity in childhood cancer survivors. CONCLUSION: Longitudinal prospective studies in more extensive cohorts are necessary to estimate actual prevalence and facilitate the unravelling of the underlying mechanisms in change of body composition.

Published 1 June 2007 in Crit Rev Oncol Hematol, 63(1): 32-46.
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