AffiliationDepartment of Endocrinology, Christie Hospital, Manchester, United Kingdom.
MetadataShow full item record
AbstractLow doses of cranial irradiation (18-24 gray) employed in the management of acute lymphoblastic leukemia may cause early or precocious puberty, predominantly in girls. To determine whether this sexual dichotomy exists at higher irradiation doses (25-47 gray), the onset of puberty was identified in 46 GH-deficient children (30 males) previously irradiated for a brain tumor not involving the hypothalamic-pituitary axis and compared with the normal pubertal standards of Marshall and Tanner. Age at irradiation was at least 2 SD below the mean age of pubertal onset in normal children. There was a significant linear association between age at irradiation and age at onset of puberty. The onset of puberty occurred at an early age in both sexes (mean, 8.51 yr in girls and 9.21 yr in boys plus 0.29 yr for every year of age at irradiation). For example, the estimated age at onset of puberty in a boy irradiated at 2 yr of age would be 9.79 yr, and that for a boy irradiated at 9 yr of age would be 11.82 yr. In the context of GH deficiency, which is usually associated with a delay in the onset of puberty, this is abnormal. At each age of irradiation, the estimated age at the onset of puberty was approximately 0.7 yr earlier in girls than boys. A similar trend was seen for bone age, which was abnormally early at the time of pubertal onset (mean, 7.39 yr in girls and 8.66 yr in boys plus 0.25 yr for every year of age at the time of irradiation). At the doses of irradiation employed in the treatment of brain tumors, radiation-induced early puberty is not restricted to girls. The clinical consequence of early puberty in the management of poor growth associated with radiation-induced GH deficiency is to foreshorten the time available for treatment with GH.
CitationCranial irradiation and early puberty. 1994, 78 (6):1282-6 J. Clin. Endocrinol. Metab.
JournalThe Journal of Clinical Endocrinology and Metabolism
- A prospective study of the development of growth hormone deficiency in children given cranial irradiation, and its relation to statural growth.
- Authors: Brauner R, Rappaport R, Prevot C, Czernichow P, Zucker JM, Bataini P, Lemerle J, Sarrazin D, Guyda HJ
- Issue date: 1989 Feb
- Precocious and premature puberty associated with treatment of acute lymphoblastic leukaemia.
- Authors: Leiper AD, Stanhope R, Kitching P, Chessells JM
- Issue date: 1987 Nov
- The pubertal growth spurt in eight patients with true precocious puberty and growth hormone deficiency: evidence for a direct role of sex steroids.
- Authors: Attie KM, Ramirez NR, Conte FA, Kaplan SL, Grumbach MM
- Issue date: 1990 Oct
- Response to growth hormone treatment and final height after cranial or craniospinal irradiation.
- Authors: Sulmont V, Brauner R, Fontoura M, Rappaport R
- Issue date: 1990 May
- Long-term effects of treatment on endocrine function in children with brain tumors.
- Authors: Duffner PK, Cohen ME, Anderson SW, Voorhess ML, MacGillivray MH, Panahon A, Brecher ML
- Issue date: 1983 Nov