Pubertal development and primary ovarian insufficiency in female survivors of embryonal brain tumors following risk-adapted craniospinal irradiation and adjuvant chemotherapy Journal Article


Authors: DeWire, M.; Green, D. M.; Sklar, C. A.; Merchant, T. E.; Wallace, D.; Lin, T.; Vern-Gross, T.; Kun, L. E.; Krasin, M. J.; Boyett, J. M.; Wright, K. D.; Wetmore, C.; Broniscer, A.; Gajjar, A.
Article Title: Pubertal development and primary ovarian insufficiency in female survivors of embryonal brain tumors following risk-adapted craniospinal irradiation and adjuvant chemotherapy
Abstract: Female survivors of central nervous system (CNS) tumors are at an increased risk for gonadal damage and variations in the timing of puberty following radiotherapy and alkylating agent-based chemotherapy. Procedure: Clinical and laboratory data were obtained from 30 evaluable female patients with newly diagnosed embryonal CNS tumors treated on a prospective protocol (SJMB 96) at St. Jude Children's Research Hospital (SJCRH). Pubertal development was evaluated by Tanner staging. Primary ovarian insufficiency (POI) was determined by Tanner staging and FSH level. Females with Tanner stage I-II and FSH>15mIU/ml, or Tanner stage III-V, FSH>25mIU/ml and FSH greater than LH were defined to have ovarian insufficiency. Recovery of ovarian function was defined as normalization of FSH without therapeutic intervention. Results: Median length of follow-up post completion of therapy was 7.2 years (4.0-10.8 years). The cumulative incidence of pubertal onset was 75.6% by the age of 13. Precocious puberty was observed in 11.1% and delayed puberty in 11.8%. The cumulative incidence of POI was 82.8%, though recovery was observed in 38.5%. Conclusions: Treatment for primary CNS embryonal tumors may cause variations in the timing of pubertal development, impacting physical and psychosocial development. Female survivors are at risk for POI, a subset of whom will recover function over time. Further refinement of therapies is needed in order to reduce late ovarian insufficiency. © 2014 Wiley Periodicals, Inc.
Keywords: puberty; medulloblastoma; ovarian dysfunction; ovarian insufficiency
Journal Title: Pediatric Blood and Cancer
Volume: 62
Issue: 2
ISSN: 1545-5009
Publisher: Wiley Periodicals, Inc  
Date Published: 2015-02-01
Start Page: 329
End Page: 334
Language: English
DOI: 10.1002/pbc.25274
PROVIDER: scopus
PMCID: PMC4402092
PUBMED: 25327609
DOI/URL:
Notes: Export Date: 4 May 2015 -- Source: Scopus
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MSK Authors
  1. Charles A Sklar
    285 Sklar