Table 1. Established Risk Factors of Short Stature and HP
Dysfunction in Childhood Cancer Survivors
Complication Host Factors High Risk Treatment Exposures
Short AH or
impaired linear
growth
• Younger age at cancer/tumor
treatment
• Precocious puberty
• Genetic syndromes (such as
neurofibromatosis type 1)
• Fanconi anemia
• Radiation fields involving the HP
region
a
• Spinal irradiation
b
• TBI
• Glucocorticoids
• TKIs
• Retinoic acid
GHD • Younger age at cancer/tumor
treatment
• Greater elapsed time since
cancer/tumor treatment
• Tumor or surgery involving the
HP region
• HP radiation ≥18 Gy
• TBI ≥10 Gy in single fraction
• TBI ≥12 Gy fractionated
CPP • Younger age at cancer/tumor
treatment
• Female sex
• Increased body mass index
• Neurofibromatosis type 1
• Tumor or surgery involving HP
region or optic pathways
• Hydrocephalus
• HP radiotherapy ≥18 Gy
LH/FSHD • Greater elapsed time since
cancer/tumor treatment
• Presence of other HP deficits
• Tumor or surgery involving the
HP region
• HP radiation ≥30 Gy
TSHD • Greater elapsed time since
cancer/tumor treatment
• Presence of other HP deficits
• Tumor or surgery involving the
HP region
• HP radiation ≥30 Gy
ACTHD • Greater elapsed time since
cancer/tumor treatment
• Presence of other HP deficits
• Tumor or surgery involving the
HP region
• HP radiation ≥30 Gy
a
Cranial, infratemporal (ear), nasopharyngeal, orbital (eye), and Waldeyer's ring.
b
Also includes fields involving the abdomen, chest, mediastinum, and pelvis.
