Insights from an advisory board: Facilitating transition of care into adulthood in brain cancer survivors with acquired pediatric growth hormone deficiency

IF 1.6 4区 医学 Q4 CELL BIOLOGY Growth Hormone & Igf Research Pub Date : 2024-02-01 DOI:10.1016/j.ghir.2024.101573
Craig Alter , Margaret Boguszewski , David Clemmons , Georgiana A. Dobri , Mitchell E. Geffner , Nicky Kelepouris , Bradley S. Miller , Richard Oh , Heidi Shea , Kevin C.J. Yuen
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引用次数: 0

Abstract

Objective

Children with growth hormone deficiency (GHD) face multiple challenges that can negatively impact the transition from pediatric to adult endocrinology care. For children with GHD resulting from brain cancer or its treatment, the involvement of oncology care providers and possible disease-related comorbidities add further complexity to this transition.

Design

An advisory board of pediatric and adult endocrinologists was convened to help better understand the unique challenges faced by childhood cancer survivors with GHD, and discuss recommendations to optimize continuity of care as these patients proceed to adulthood. Topics included the benefits and risks of growth hormone (GH) therapy in cancer survivors, the importance of initiating GH replacement therapy early in the patient's journey and continuing into adulthood, and the obstacles that can limit an effective transition to adult care for these patients.

Results/conclusions

Some identified obstacles included the need to prioritize cancer treatment over treatment for GHD, a lack of patient and oncologist knowledge about the full range of benefits provided by long-term GH administration, concerns about tumor recurrence risk in cancer survivors receiving GH treatment, and suboptimal communication and coordination (e.g., referrals) between care providers, all of which could potentially result in treatment gaps or even complete loss of follow-up during the care transition. Advisors provided recommendations for increasing education for patients and care providers and improving coordination between treatment team members, both of which are intended to help improve continuity of care to maximize the health benefits of GH administration during the critical period when childhood cancer survivors transition into adulthood.

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咨询委员会的见解:促进后天性小儿生长激素缺乏症脑癌幸存者向成年期的护理过渡
目的生长激素缺乏症(GHD)患儿面临着多种挑战,这些挑战可能会对从儿科内分泌治疗向成人内分泌治疗的过渡产生负面影响。设计召集了一个由儿科和成人内分泌专家组成的咨询委员会,以帮助更好地了解患有生长激素缺乏症的儿童癌症幸存者所面临的独特挑战,并讨论在这些患者进入成年期时优化护理连续性的建议。讨论的主题包括生长激素 (GH) 治疗对癌症幸存者的益处和风险、在患者早期开始 GH 替代治疗并持续到成年的重要性,以及可能限制这些患者有效过渡到成人护理的障碍。结果/结论已发现的一些障碍包括:需要优先考虑癌症治疗而不是 GHD 治疗;患者和肿瘤学家缺乏对长期服用 GH 所带来的全部益处的了解;担心接受 GH 治疗的癌症幸存者的肿瘤复发风险;以及医疗服务提供者之间的沟通和协调(如转诊)不够理想、转诊),所有这些都有可能导致治疗缺口,甚至在治疗过渡期间完全失去随访。顾问们建议加强对患者和护理提供者的教育,并改善治疗团队成员之间的协调,这两点都旨在帮助改善护理的连续性,以便在儿童癌症幸存者向成年过渡的关键时期最大限度地发挥GH治疗对健康的益处。
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来源期刊
Growth Hormone & Igf Research
Growth Hormone & Igf Research 医学-内分泌学与代谢
CiteScore
3.30
自引率
0.00%
发文量
38
审稿时长
57 days
期刊介绍: Growth Hormone & IGF Research is a forum for research on the regulation of growth and metabolism in humans, animals, tissues and cells. It publishes articles on all aspects of growth-promoting and growth-inhibiting hormones and factors, with particular emphasis on insulin-like growth factors (IGFs) and growth hormone. This reflects the increasing importance of growth hormone and IGFs in clinical medicine and in the treatment of diseases.
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