Endocrine Abstracts

Introduction: Childhood cancer incidence increases all over the world, but it are optimistic that more than seventy percent of children with cancer survive due to radiation and chemotherapy. However cancer treatment may impair reproductive function. The aim of this study is to investigate level of pituitary hormones, testis/ovarian volume in women and men undergo cranial and craniospinal irradiation in childhood.

Methods: Participators were examined with ultrasound, hormonal analyze. 22 women and 12 men were included in this study.

Group 1 included 11 women and 11 men, after treatment for brain tumors in childhood. The median age of participators was 19.5 (16–25), the median age at original diagnosis was 11.4 (5–15). All patient received craniospinal irradiation 55 Gy and chemotherapy M-2000.

Group 2 included 11 women and 2 men after treatment for lymphoblastic leukemia. The median age of participators was 21.5 (16–30), age at original diagnosis – 7.7 (2.5–13). All patients received cranial irradiation 18 Gy, chemotherapy BFM-90.

Results: women after cranial irradiation had amenorrhea with depletion of follicles, high gonadotropin levels. Survivors after craniospinal irradiation had smaller ovarian volume per ovary than after cranial irradiation (average, 3,3 vs. 8.7 cm³; P<0.001), and higher LH (13.17 vs 4.5)and FSH (31.6 vs 5.65).

In men after craniospinal irradiation was detected lower testicular volume (7.03 vs 11.25), FSH level (13.4 vs 7.62). There were no significant differences in LH, testosterone, prolactin levels.

Conclusion: Women after craniospinal irradiation more likely had primary hypogonadism. Survivors with preserved menstrual cycles had sonographic and endocrine changes suggesting impairment of ovarian reserve. Men after cranspinal had lower testicular volume and FSH level with normal testosterone, LH that suggested impaired spermatogenesis. None of participates had low gonadotropins. Thus craniospinal irradiation has a great impact on reproductive function in childhood cancer survivals.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.