Growth and pubertal development in survivors of childhood cancer

Linear growth and final adult stature in survivors of childhood cancer may be affected adversely by the disease itself as well as by the treatments utilized. The endocrine causes of impaired growth, which include growth hormone deficiency, primary thyroid dysfunction, and premature sexual maturation, are generally the consequence of radiation therapy. Growth failure is most prominent following craniospinal irradiation for brain tumors and total body irradiation for bone marrow transplantation. Pubertal development in both males and females is generally unaffected by chemotherapy. Leydig cell failure is seen most often after direct testicular irradiation with doses greater than 20 Gy. Ovarian failure is seen commonly following abdominal, craniospinal and total body irradiation.