[PDF][PDF] Effects of radiation on testicular function in long-term survivors of childhood acute lymphoblastic leukemia: a report from the Children Cancer Study Group.

CA Sklar, LL Robison, ME Nesbit, HN Sather… - Journal of Clinical …, 1990 - Citeseer
CA Sklar, LL Robison, ME Nesbit, HN Sather, AT Meadows, JA Ortega, TH Kim…
Journal of Clinical Oncology, 1990Citeseer
Testicular function was evaluated in 60 long-term survivors of childhood acute lymphoblastic
leukemia (ALL). All the patients were treated on two consecutive Childrens Cancer Study
Group protocols and received identical chemotherapy and either 18 or 24 Gy radia-tion
therapy (RT) to one of the following fields: craniospinal plus 12 Gy abdominal RT including
the gonads (group 1); craniospinal (group 2); or cranial (group 3). The median age at the
time of their last evaluation was 14.5 years (range, 10.5 to 25.7), which took place a median …
Testicular function was evaluated in 60 long-term survivors of childhood acute lymphoblastic leukemia (ALL). All the patients were treated on two consecutive Childrens Cancer Study Group protocols and received identical chemotherapy and either 18 or 24 Gy radia-tion therapy (RT) to one of the following fields: craniospinal plus 12 Gy abdominal RT including the gonads (group 1); craniospinal (group 2); or cranial (group 3). The median age at the time of their last evaluation was 14.5 years (range, 10.5 to 25.7), which took place a median of 5.0 years (range, 1 to 10.3) after discontinuing therapy. The incidence of primary germ cell dysfunction as judged by raised levels of follicle-stimulating hormone (FSH) and/or reduced testicular volume was significantly associated
ABNORMALITIES of gonadal function have 1 been reported following the treatment of a variety of childhood cancers.'Gonadal dysfunction can result from either direct damage to the gonad by chemotherapy and radiation therapy (RT) or from damage to the hypothalamicpituitary unit as a consequence of cranial irradiation. The latter appears to be a relatively infrequent cause of gonadal failure and develops most commonly following high-dose (> 35 Gy) cranial RT for CNS tumors. 2'3 Thus, for most children undergoing treatment for a malignancy including acute lymphoblastic leukemia (ALL), ultimate gonadal damage is dependent on the type of chemotherapy used and the proximity of the gonads to the field of RT. While information is available regarding the gonadal toxicity of various chemotherapeutic agents, 4'5 much less is known concerning the effects of radiation on the
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