title: Age at menarche in childhood cancer survivors: results of a nationwide survey in Germany.
abstract: OBJECTIVE
  With rising cure rates of childhood cancer, side effects of treatment are attracting increasing interest. The present analysis evaluates the influence of tumor localization, radiotherapy and chemotherapy on the age of menarche.
  
  
  METHODS
  4,689 former pediatric oncology patients, diagnosed 1980-2004, were contacted in collaboration with the German Childhood Cancer Registry.
  
  
  RESULTS
  1,036 out of 1,461 female participants reported their age at menarche and had an oncological diagnosis before menarche. The median age at menarche was 13 years, compared to 12.8 years in the German general population. A significant delay of menarche was seen in patients with pituitary radiation doses of ≥30 Gy (mean 13.6 years, SD 2.2) compared to <30 Gy (mean 12.5 years, SD 1.4, p = 0.05). Patients with additional spinal radiation were even older at menarche (mean 14.4 years, SD 2.5). Pelvic and pelvic-near radiation significantly delayed onset of menarche (mean 14.0 years, SD 1.9 and mean 14.3, SD 2.6, respectively, p < 0.001). Only some chemotherapeutic agents (carboplatin/cisplatin, etoposide) were associated with a menarcheal delay of <1 year.
  
  
  CONCLUSIONS
  Overall, female childhood cancer survivors showed a normal menarcheal age. Pituitary radiation dosage of ≥30 Gy, spinal and pelvic radiotherapy were associated with a moderate delay in the occurrence of menarche.
authors.affiliation: Department of Pediatric Endocrinology, Charité University Hospital, Augustenburger Platz 1, Berlin, Germany.
authors.forename: Theda
authors.initials: T
authors.lastname: Wessel
authors.forename: Magdalena
authors.initials: M
authors.lastname: Balcerek
authors.forename: Simone
authors.initials: S
authors.lastname: Reinmuth
authors.forename: Cynthia
authors.initials: C
authors.lastname: Hohmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Keil
authors.forename: Guenter
authors.initials: G
authors.lastname: Henze
authors.forename: Anja
authors.initials: A
authors.lastname: Borgmann-Staudt
mesh_terms: D000367:Age Factors; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005858:Germany; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008572:Menarche / Q000187:drug effects* / Q000528:radiation effects*; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy*; D010388:Pelvis / Q000528:radiation effects; D010902:Pituitary Gland / Q000528:radiation effects; D012042:Registries; D012189:Retrospective Studies; D013131:Spine / Q000528:radiation effects; D017741:Survivors
chemical_list: D000970:Antineoplastic Agents