Gonadal and growth impairment in childhood cancer survivors' cohort

BACKGROUND: Childhood cancer survivors (CCSs) are at risk of developing hypogonadotropic hypogonadism (HH) and growth failure due to cancer therapies. Early detection is crucial for preventing long-term sequelae. OBJECTIVES: To determine the prevalence of Growth failure and HH among CCSs and assess associated risk factors, including cranial radiotherapy and chemotherapy exposure. METHODS: A cross-sectional study was conducted among 92 CCSs aged 14–25 years at a tertiary center over 18 months. Detailed clinical examinations, Tanner staging, and hormonal evaluations were performed. Growth failure was assessed via IAP growth charts. Associations with treatment variables were analyzed. RESULTS: The mean time since the completion of therapy was 4.9 ± 1.8 years. Growth failure and suspected HH were present in 18 (19.6%) and 2 (2.2%) participants, one of whom had received cranial radiotherapy. Cranial radiotherapy, cumulative anthracycline dose, and methotrexate administration were significantly associated with growth failure. Early pubertal screening and endocrine follow-up are essential for timely intervention. CONCLUSIONS: While the prevalence of Growth failure in this cohort appeared lower than international reports, the small sample size and low event count limit definitive conclusions. Although limited by small numbers, observed associations suggest a potential link between cranial irradiation and cumulative chemotherapy exposure with HH and growth failure, meriting further prospective study. Regular endocrine surveillance from the completion of therapy is crucial to improve growth and reproductive outcomes in CCS.