To determine if a relationship exists between age at irradiation, sex of the patient, and age at onset of puberty and pubarche in children treated with high-dose radiation to the central nervous system.
Tertiary care institutional practices and clinics.
Thirty-six children treated with high-dose irradiation (hypothalamic pituitary dose, 30-72 Gy) by conventional (n=29) or hyperfractionated (n=7) schedules. Girls were treated before age 8 years and boys before age 9 years. Twenty-six of the 36 children also received chemotherapy. All tumors were distant from the hypothalamic-pituitary region.
Main Outcome Measure:
Age at onset of puberty and pubarche.
In girls, the median age at onset of puberty was 9.3 years vs 10.9 years for controls (P<.01); pubarche occurred at 9.4 years vs 11.2 years for controls (P<.01). In boys, the median age at onset of puberty—genital II—was 11.0 years vs 11.5 years for controls (P=.30); pubarche occurred at a median age of 10.5 years vs 12 years for controls (P=.25). A censored-data normal linear regression model was used to account for children (n=6) who had not reached puberty. Age at diagnosis (P<.01) and sex (P=.01) were significant predictors of age at onset of puberty. Body mass index SD score (z score) was inversely related to age at onset of puberty (r=−0.77) and was greater at onset of puberty in girls than in boys.
In children who have received high-dose cranial radiation therapy, a significant positive correlation exists between age at diagnosis and age at onset of puberty in boys and girls.(Arch Pediatr Adolesc Med. 1996;150:589-592)
Oberfield SE, Soranno D, Nirenberg A, Heller G, Allen JC, David R, Levine LS, Sklar CA. Age at Onset of Puberty Following High-Dose Central Nervous System Radiation Therapy. Arch Pediatr Adolesc Med. 1996;150(6):589-592. doi:10.1001/archpedi.1996.02170310023003