Gonadal function recovery in very long-term male survivors of childhood cancer (original) (raw)
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Treatment-related gonadotoxicity in young male cancer survivors: a comparative cross-sectional study
Pediatria Polska, 2018
Introduction: Male gonads are susceptible to the deleterious effect of anticancer therapy (chemotherapy, radiation to the pelvis, central nervous system, or total body irradiation). Hormonal dysfunction after anticancer treatment was evaluated in young male cancer survivors. Material and methods: In 153 male adolescent cancer survivors divided into three risk groups (low-LR, moderate-MR, and high-HR) and 24 controls, gonadal and pituitary hormones were analysed. FSH, LH, and testosterone levels were assessed in all the studied patients using immunoenzymatic techniques, dimeric inhibin B-by ELISA method. Results: All cancer survivor groups had lower mean values of inhibin B (86.87 ±69.07 ng/l vs. 161.07 ±60.64 ng/l; p < 0.001), and higher FSH (10.23 ±13.35 mIU/l vs. 4.38 ±2.39 mIU/l; p < 0.001) and LH (5.0 ±3.43 IU/l vs. 3.58 ±2.17 IU/l; p = 0.016); testosterone levels were comparable to the controls. Abnormal values of inhibin B were found: in 15.2% of survivors in LR, 47.6% in MR, and 94.1%-in the HR group. Elevated FSH levels were seen in 20.4% of survivors in LR, 47.4% in MR, and 92.2% in the HR group. The inhibin B: FSH ratio
Gonadal function in boys with newly diagnosed cancer before the start of treatment
Human reproduction (Oxford, England), 2016
Are Inhibin B and testosterone levels reduced in boys with newly diagnosed cancer prior to therapy? Pretreatment serum levels of Inhibin B and testosterone are significantly reduced in boys with newly diagnosed cancer, compared to reference values. Disease-related gonadal impairment has been demonstrated in girls and young women diagnosed with cancer, prior to therapy. We conducted a descriptive study in boys newly diagnosed with cancer between January 2006 and February 2014. Serum Inhibin B and testosterone levels were determined in 224 boys, up to the age of 18 years, with newly diagnosed cancer prior to therapy. Hormone levels were compared with age-matched reference values. The cohort consisted of patients with acute lymphoblastic leukaemia (ALL), acute myeloid leukaemia (AML), Hodgkin lymphoma (HL), non-Hodgkin lym-phoma (NHL), nephroblastoma, neuroblastoma and sarcoma. This study demonstrates reduced serum levels of Inhibin B in boys with newly diagnosed cancer, compared to re...
The Lancet. Oncology, 2017
Treatment with chemotherapy, radiotherapy, or surgery that involves reproductive organs can cause impaired spermatogenesis, testosterone deficiency, and physical sexual dysfunction in male pubertal, adolescent, and young adult cancer survivors. Guidelines for surveillance and management of potential adverse effects could improve cancer survivors' health and quality of life. Surveillance recommendations vary considerably, causing uncertainty about optimum screening practices. This clinical practice guideline recommended by the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium, developed using evidence-based methodology, critically synthesises surveillance recommendations for gonadotoxicity in male childhood, adolescent, and young adult (CAYA) cancer survivors. The recommendations were developed by an international multidisciplinary panel including 25 experts in relevant medical specialties, using a cons...
European Journal of Endocrinology, 2013
Background: Although gonadal toxicity has been reported, no data are available on recovery of gonadal function in very long-term survivors of childhood cancer. Inhibin B is a novel reliable serum marker which has been shown to be of value in childhood cancer survivor studies to identify risk groups for impaired gonadal function, but consecutive long-term follow-up studies using serum inhibin B as a marker are not available. Objective: To evaluate possible recovery of gonadal dysfunction over time in adult male survivors of childhood cancer. Methods: In this retrospective study, adult male long-term childhood cancer survivors (n = 201) who visited our outpatient late effects clinic were included and we used inhibin B as a surrogate marker for gonadal function. Results: Median age at diagnosis was 5.9 years (range 0.0-17.5) and discontinuation of treatment was reached at a median age of 8.2 years (range 0.0-20.8). Inhibin B levels were first 0959-8049/$ -see front matter Ó
Gonadal Status in Male Survivors following Childhood Brain Tumors 1
The Journal of Clinical Endocrinology & Metabolism, 2001
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
Journal of Adolescent and Young Adult Oncology
Purpose: To determine the relationship between pubertal development and postpubertal gonadal function in childhood cancer survivors. Methods: Childhood cancer survivors (q10 years of age) who received follow-up care in a pediatric oncology group in an academic medical center during the period from January 1, 1985, to July 1, 2010 were included in this case series. Their pubertal development and gonadal function were evaluated. Results: The cohort consists of 39 males (age 10-21 years) and 35 females (age 10-29 years) with a variety of cancer diagnosis and treatments. The average age at diagnosis was *7.5 years. The average age at the time of the study was 16 and 16.7 years in males and females, respectively, representing a mean follow-up interval of *9 years. Despite the fact that 60% of survivors received cyclophosphamide equivalents and 16.2% received cranial radiation or brain tumor resection, the majority of survivors (68%) presented with both normal puberty and normal gonadal functions at the time of follow-up. In 27% of survivors, puberty development did not predict gonadal function in early adulthood: 20% of survivors had normal puberty, but abnormal gonadal function; 7% of survivors had abnormal puberty, but gonadal function remained normal as young adults. Conclusions: Most childhood cancer survivors had normal puberty and gonadal function despite a variety of cancer treatment modalities. However, normal puberty did not predict normal gonadal function later in life in many survivors. Therefore, close follow-up with gonadal function in adolescent and early adulthood years is essential.
Journal of Pediatric Endocrinology and Metabolism, 2000
Objective: Inhibin Β produced by Sertoli cells may be an important marker of seminiferous tubule function in patients treated with chemotherapy (CT). The aim of this study was to evaluate the inhibin B/FSH ratio to detect male gonadal dysfunction in cancer survivors treated in childhood and adolescence. Patients: Twenty-one male patients (group A) treated with 6-10 courses of CT for Hodgkin's disease during childhood and adolescence were examined 3-11 years after the conclusion of treatment. Twenty healthy young men (18-23 years old) were used as controls (group B). Methods: Serum samples for the determination of inhibin B, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), sex hormone-binding globulin (SHBG) and semen for analysis were collected. Results: The median testicular volume of patients of group A was lower than those of group Β (ρ = 0.001) and a positive correlation was found between testicular size and sperm count (r =-0.5, ρ = 0.01). Semen analysis revealed azoospermia in 11 patients, severe oligospermia in four and normal sperm count in three. No significant difference was found in the median of T, LH, SHBG, inhibin Β concentrations and T/LH ratio between the groups. Serum inhibin Β was correlated with the serum FSH levels (r =
The effect of cancer therapy on gonadal function
Seminars in Oncology Nursing, 1985
ABSTRACT Surgery for genitourinary cancer, gynecological cancer, and colorectal cancer often leads to organic sexual dysfunction due to resection of the primary sexual organs themselves or their nerve supply. Radiation also damages these tissues, often to a lesser degree with regard to some functions, but producing sterility with the gonads receive doses in excess of a threshold level approximating 600 rads. Several tumors involving younger patients are of particular concern because such patients often are cured and may desire to remain fertile. Hodgkin's disease, lymphoblastic leukemia, and testicular cancer are examples of such tumors. Hodgkin's disease may be cured by radiation in some cases, and oophoropexy offers a means of protecting the ovary. However, when intensive combination chemotherapy is required for cure, there is little that can be done to prevent a high risk of sterility.The following papers in this issue of Seminars deal with the psychological aspects of sexuality in the cancer patient, several specific organ systems of special concern, sperm banking, pregnancy and cancer, assessment and counseling techniques, and implications for nursing education.