Adult height and age at menarche in childhood cancer survivors.
The aim of this study was to assess the long-term effects of cancer treatments on adult height and age at menarche in survivors of various types of childhood cancer. 285 childhood cancer survivors (161 men and 124 women), at least 18 years old and having been off treatment for at least 5 years, were examined. The effects of cranial (CrRT) and craniospinal irradiation (CrSpRT), other treatments and age at diagnosis on adult height and age at menarche were investigated. Patients who did not receive CrRT or CrSpRT, reached normal adult heights. However, a significant reduction in adult height was observed in men and women treated with CrRT or CrSpRT, especially if the treatment was given at the age of 8 years or younger. In girls, CrRT resulted in a significantly earlier menarche, compared with the Dutch population. Chemotherapy, radiation dose and age at menarche did not affect adult height. The relative risk (RR) of attaining an adult height below the 3rd percentile (20% 49/244) of the study population) was 6 times increased (RR=6.4; 95% confidence interval (CI) 1.46-28.52) after CrSpRT, 4 times (RR=4.2; 95% CI 1.81-9.63) after Crth and 5 times (RR=51; 95% CI 2.23-11.59) when irradiation was administered at the age of 8 years or younger. CrRT and CrSpRT and age at treatment are the main determinants of short stature in male and female childhood cancer survivors.
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Emma Kinderziekenhuis, Department of Pediatric Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. emnoorda@hotmail.com
Somers
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van Leeuwen
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Vulsma
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Behrendt
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D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001827:Body Height / Q000528:radiation effects*; D002648:Child; D016371:Cranial Irradiation / Q000009:adverse effects*; D018572:Disease-Free Survival; D005260:Female; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D008297:Male; D008572:Menarche / Q000528:radiation effects*; D009369:Neoplasms / Q000532:radiotherapy*; D017678:Sex Distribution; D017741:Survivors