Adult height and age at menarche in childhood cancer survivors

Noorda, Eva M.; Somers, R.; Leeuwen, F.E. van; Vulsma, Thomas; Behrendt, H.

doi:10.1016/s0959-8049(00)00438-x

Cited by 48 publications

(35 citation statements)

References 23 publications

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“…Studies among childhood cancer survivors have demonstrated a higher susceptibility to radiation-induced growth disorders among those treated at the youngest ages (19,21). However, in agreement with two other studies (23,38), we found no evidence of reduced adult height among subjects treated with NRI in childhood.…”

supporting

confidence: 90%

“…Among NRI-exposed females, no increased risks were seen for early menarche, early menopause, or fertility problems, reproductive characteristics that can be affected in women who were treated with high-dose cranial radiation, especially at young ages (19,40). Yeh and others (18,22) recently reported on prolonged follow-up (Ͼ40 y) of a Maryland cohort of subjects exposed to NRI during childhood, but at higher doses compared with our study.…”

contrasting

confidence: 61%

“…Exposed subjects and nonexposed subjects were equally likely to be shorter than the third percentile of adult stature in the Netherlands [1.57 m for females and 1.69 m for males (19)], after adjustment for age at treatment, attained age, and sex. Subjects exposed to the highest radiation doses to the pituitary gland (Ն20 cGy) were even less likely than lessexposed subjects (1-19 cGy) to be shorter than the sex-specific third percentile.…”

mentioning

confidence: 99%

“…Chronic neuroendocrine sequelae such as disturbances of GH and gonadotropin (LH and FSH) regulatory processes are well known among cancer patients and patients with pituitary disease, who received high-dose radiation therapy involving the pituitary-hypothalamic axis (cranial doses Ͼ18 Gy) (19,20,37). Studies among childhood cancer survivors have demonstrated a higher susceptibility to radiation-induced growth disorders among those treated at the youngest ages (19,21).…”

mentioning

confidence: 99%

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Late Health Effects of Childhood Nasopharyngeal Radium Irradiation: Nonmelanoma Skin Cancers, Benign Tumors, and Hormonal Disorders

RONCKERS

2002

Pediatric Research

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Nasopharyngeal radium irradiation (NRI) was widely used from 1940 through 1970 to treat otitis serosa in children and barotrauma in airmen and submariners. We assessed whether NRI-exposed individuals were at higher risk for benign tumors, nonmelanoma skin cancer, thyroid disorders, and conditions related to regulatory control of anterior pituitary hormones, such as growth and reproductive characteristics. We conducted a retrospective cohort study in 3440 NRI-exposed and 3088 nonexposed subjects, who as children were treated at nine ear, nose and throat clinics in The Netherlands between 1945 and 1981. Based on information from original medical records, we traced vital status through follow-up at municipal population registries. Disease status (including medical confirmation) and indicators of pituitary gland radiation damage were assessed from a selfadministered questionnaire in 1997. The average radiation doses were 11, 7, and 1.5 cGy for pituitary, parotid, and thyroid gland, respectively, and 3.2 cGy for the facial skin. Among exposed subjects, 23 benign head and neck tumors were observed, compared with 21 among nonexposed subjects. Elevated risk of basal cell carcinoma of the head and neck area was observed in exposed subjects (odds ratio ϭ 2.6; 95% confidence interval: 1.0 -6.7). Exposed and nonexposed groups did not differ substantially with regard to thyroid disorders, height, and reproductive characteristics, although exposed males more frequently reported a history of fertility problems compared with nonexposed males (odds ratio ϭ 1.4; 95% confidence interval: 1.0 -2.1). We found no evidence of highly elevated risk of benign head and neck tumors, nonmelanoma skin cancer, thyroid disorders, or indicators of pituitary radiation damage after childhood NRI in The Netherlands. From the early 1940s until 1960, NRI was regarded as a safe and effective treatment for (childhood) otitis serosa (1-4) and barotrauma (aerotitis media) in military submariners and airmen (5, 6). These conditions are characterized by lymphoid hyperplasia in the nasopharynx, causing impaired eustachian tube functioning, hearing loss, and pain. In the late 1920s, Dr. S.J. Crowe developed a small radium applicator attached to a pin that could be inserted through the nostrils into the nasopharynx, where the radium exerted its activity on the "overflow of lymphoid tissue" (1, 2). NRI was used in several European countries, the United States, and Canada (7,8). The Centers for Disease Control and Prevention has estimated that between 0.5 and 2 million children were treated in the United States, as well as 8000 military submariners and aviators (7).After childhood radiation exposure, elevated risks of benign head and neck tumors and NMSC have been reported (9 -12), as well as benign radiation-related disorders of the thyroid, e.g. nodular disease and hypothyroidism (13,14). However, compared with NRI-exposed subjects, radiation doses to relevant organs were higher in the latter studies. In NRI, the pituitary gland receives relatively high dose...

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supporting

confidence: 90%

contrasting

confidence: 61%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Late Health Effects of Childhood Nasopharyngeal Radium Irradiation: Nonmelanoma Skin Cancers, Benign Tumors, and Hormonal Disorders

RONCKERS

2002

Pediatric Research

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“…Screening for low body mineral density is recommended for survivors treated with hematopoietic stem cell transplant, methotrexate, and steroids. Problems with growth [4], weight [5], puberty and gonadal function [6], bone health [7], thyroid function [8], and adrenal function [9] have been described.…”

Section: Introductionmentioning

confidence: 99%

Endocrine health problems detected in 764 patients evaluated in a late effects clinic

Pereira¹,

Pereira²,

Dias³

et al. 2017

EJEA

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Background: Many pediatric cancer survivors have endocrine conditions. After treatment with alkylating agents, steroids, methotrexate, and radiation, several endocrine dysfunctions may appear. Surveillance for late effects is recommended by guidelines worldwide. Objective: The objective of this study was to describe the endocrine outcomes of 764 patients followed during a 20 years' period in our out-patient clinic. Design: We retrospectively reviewed the medical records. Patients: The study included 764 patients whose oncological or hematological dangerous diseases appeared before they were 18 years old. Larger groups were constituted by leukemias, central nervous tumors, and lymphomas. Outcome Measures: The frequency and types of endocrine conditions were analyzed. Results: 1,091 endocrine conditions were observed in all groups. The most common types of endocrine conditions were problems with growth and the thyroid. We found puberty abnormalities and bone problems in third and fourth places of frequency. ACTH insufficiency was found in seventh place. Conclusion: Endocrine dysfunctions are very common in survivor populations. Endocrinologists should be aware of international guidelines and make an effort to optimize Case Rep Oncol 2017;10:958-963

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Abnormal timing of menarche in survivors of central nervous system tumors

Armstrong

Whitton

Gajjar

et al. 2009

Cancer

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BACKGROUND: Children who receive high‐dose radiotherapy to the hypothalamic‐pituitary (H‐P) axis may be at risk for both early and late puberty. To the authors' knowledge, data regarding the risk of altered timing of menarche after higher dose radiotherapy (RT), as used in the treatment of central nervous system (CNS) tumors, are limited. METHODS: The authors evaluated 235 female survivors of CNS tumors, diagnosed between 1970 and 1986, and >1000 sibling controls who were participants in the Childhood Cancer Survivor Study, and provided self‐reported data concerning age at menarche. RESULTS: Survivors of CNS tumors were more likely to have onset of menarche before age 10 years compared with their siblings (11.9% vs 1.0%) (odds ratio [OR], 14.1; 95% confidence interval [95% CI], 7.0‐30.9). Of the 138 survivors who received RT to the H‐P axis, 20 (14.5%) had onset of menarche before age 10 years, compared with 4.3% of those who did not receive RT (OR, 3.8; 95% CI, 1.2‐16.5). Age ≤4 years at the time of diagnosis was associated with an increased risk (OR, 4.0; 95% CI, 1.7‐10.0) of early menarche. In addition, survivors of CNS tumors were more likely than siblings to have onset of menarche after age 16 years (10.6% vs 1.9%) (OR, 6.6; 95% CI, 3.4‐11.4). Doses of RT to the H‐P axis >50 gray OR, 9.0; 95% CI, 2.3‐59.5) and spinal RT conferred an increased risk of late menarche, as did older age (>10 years) at the time of diagnosis (OR, 3.0; 95% CI, 1.3‐7.0). CONCLUSIONS: Survivors of CNS tumors are at a significantly increased risk of both early and late menarche associated with RT exposure and age at treatment. Cancer 2009. © 2009 American Cancer Society.

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Adult height and age at menarche in childhood cancer survivors

Cited by 48 publications

References 23 publications

Late Health Effects of Childhood Nasopharyngeal Radium Irradiation: Nonmelanoma Skin Cancers, Benign Tumors, and Hormonal Disorders

Late Health Effects of Childhood Nasopharyngeal Radium Irradiation: Nonmelanoma Skin Cancers, Benign Tumors, and Hormonal Disorders

Endocrine health problems detected in 764 patients evaluated in a late effects clinic

Abnormal timing of menarche in survivors of central nervous system tumors

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