Alterations in pubertal timing following therapy for childhood malignancies Journal Article


Authors: Armstrong, G. T.; Chow, E. J.; Sklar, C. A.
Article Title: Alterations in pubertal timing following therapy for childhood malignancies
Abstract: The onset of puberty marks a time of rapid linear growth, sexual development, and transition from childhood to maturity. The diagnosis and treatment of a childhood malignancy prior to the onset of puberty has the potential to profoundly affect the timing and the tempo of puberty. CNS tumors located in the hypothalamic-pituitary (H-P) region, surgical resection in this location, and exposure to CNS radiotherapy are all associated with both precocious and delayed puberty. Also, chemotherapy and radiation can directly damage the gonads, which can result in absent, arrested, or delayed puberty. As a consequence of these alterations of pubertal timing, both male and female survivors of childhood cancer may be at risk of adult short-stature, decreased bone-mineral density, absent or incomplete sexual development, and ultimately, reduced rates of fertility. Appropriate and timely assessment of survivors at high risk of alterations in pubertal development will enable the identification of patients who would benefit from early medical intervention. © 2009 S. Karger AG, Basel.
Keywords: adolescent; adult; child; cancer surgery; busulfan; prednisone; review; cisplatin; cancer combination chemotherapy; pathophysiology; radiation dose; methotrexate; drug megadose; neoplasm; neoplasms; disease association; radiotherapy; clinical assessment; cyclophosphamide; melphalan; carmustine; chlormethine; gonadorelin; gonadotropin; growth hormone; ifosfamide; lomustine; procarbazine; thiotepa; vinblastine; acute lymphoblastic leukemia; bone density; central nervous system tumor; childhood cancer; delayed puberty; gonad dysfunction; groups by age; growth hormone deficiency; high risk patient; hodgkin disease; hypothalamus hypophysis system; infertility; leydig cell; ovary follicle; ovary insufficiency; patient identification; precocious puberty; radiation exposure; radiation response; sexual development; short stature; skull irradiation; survivor; testis disease; central nervous system; gonadal disease; physiology; puberty; time; cranial irradiation; gonadal disorders; time factors
Journal Title: Endocrine Development
Volume: 15
ISSN: 1421-7082
Publisher: S. Karger AG  
Date Published: 2009-01-01
Start Page: 25
End Page: 39
Language: English
DOI: 10.1159/000207616
PUBMED: 19293602
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "Source: Scopus"
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  1. Charles A Sklar
    322 Sklar