Gonadal Status in Male Survivors following Childhood Brain Tumors 1 (original) (raw)

2001, The Journal of Clinical Endocrinology & Metabolism

The effect of radiotherapy (RT) and chemotherapy (CT) on gonadal function was assessed in males treated for a childhood brain tumor not directly involving the hypothalamus/pituitary (HP) axis in a population-based study with a long follow-up time. All males Ͻ15 yr at the time of diagnosis (median: 9.0 yr, range: 0.8 to14.9 yr) and diagnosed from January 1970 through February 1997 in the eastern part of Denmark and [gte]18 yr at the time of follow-up (median: 25.8 yr, range:18.5 to 39.3 yr) were included. Thirty males fulfilled the criteria. The median age at time of RT was 9.0 yr (range: 0.8 to 14.9 yr) and the median length of follow-up was 18 yr (range: 2.0 to 28.0 yr). The biological effective dose of RT was determined to the HP region and to the spine and expressed in gray because the biological effective dose gives a means of expressing the biological effect on normal tissue of different dosage schedules in a uniform way. Levels of serum FSH, luteinizing hormone (LH), sexual hormone-binding globulin, testosterone, and inhibin B were measured and compared with healthy age-matched male controls (n ϭ 347), and the patients had a GnRH stimulation test performed with determination of peak FSH and LH. Patients treated with RT ϩ CT (n ϭ 13), compared with patients treated with RT only (n ϭ 17), had significantly higher median peak FSH (8.33 vs. 3.79 IU/L, P ϭ 0.03) and median peak LH (20.0 vs. 12.8 IU/L, P ϭ 0.03), and significantly lower median inhibin B (86.0 vs. 270 pg/ml, P ϭ 0.03), and median inhibin B/FSH ratio (12.8 vs. 107.9, P ϭ 0.04), which indicates gonadal damage. Inhibin B and inhibin B/FSH ratio were also significantly lower in the RT ϩ CT group, compared