title: Impact of cranial irradiation and brain tumor location on fertility: a survey.
abstract: As survival rates of patients with childhood brain tumors have increased to 75%, treatment related side effects are of particular importance. The present study evaluated questionnaire-based fertility characteristics in cancer survivors treated with irradiation to the hypo-thalamic-pituitary-axis.A nationwide survey was conducted in collaboration with the German Childhood Cancer Registry. Questionnaire and treatment data could be retrieved for 1110 former childhood cancer patients with cranial irradiation and/or chemotherapy.Survivors receiving ≥30 gray vs. 18-29 gray and 0-17 gray to the pituitary gland reported less pregnancies or less with their partners (7.4% vs. 32.8% vs. 12.4%; p<0.001), were more often infertile (40% vs. 9.4% vs. 12.5%; p<0.001) and the female participants, had a higher frequency of permanent amenorrhea (16.7% vs. 1.7% vs. 0%; p<0.001).Irradiation of the pituitary gland ≥ 30 gray seemed to be associated with less pregnancies and increased permanent amenorrhea in women. Future studies need to be conducted to confirm these results. Increased knowledge of treatment related side effects might help brain tumor patients to improve their family planning if necessary by gonadotropine replacement.
authors.affiliation: Paediatric Oncology/Haematology, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Koustenis
authors.forename: C
authors.initials: C
authors.lastname: Pfitzer
authors.forename: M
authors.initials: M
authors.lastname: Balcerek
authors.forename: S
authors.initials: S
authors.lastname: Reinmuth
authors.forename: A
authors.initials: A
authors.lastname: Zynda
authors.forename: C
authors.initials: C
authors.lastname: Stromberger
authors.forename: C
authors.initials: C
authors.lastname: Hohmann
authors.forename: T
authors.initials: T
authors.lastname: Keil
authors.forename: A
authors.initials: A
authors.lastname: Borgmann-Staudt
mesh_terms: D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D001921:Brain / Q000528:radiation effects*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D005858:Germany; D006306:Health Surveys; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000528:radiation effects*; D007223:Infant; D007246:Infertility / Q000209:etiology*; D008137:Longitudinal Studies; D008297:Male; D011247:Pregnancy; D011832:Radiation Injuries / Q000209:etiology*; D011879:Radiotherapy Dosage; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D017741:Survivors; D055815:Young Adult