Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Mar;84(3):361-71.
doi: 10.1111/cen.12964. Epub 2015 Nov 16.

Central precocious puberty following the diagnosis and treatment of paediatric cancer and central nervous system tumours: presentation and long-term outcomes

Wassim Chemaitilly  1   2 , Thomas E Merchant  3 , Zhenghong Li  2 , Nicole Barnes  1 , Gregory T Armstrong  2   4 , Kirsten K Ness  2 , Ching-Hon Pui  5 , Larry E Kun  3 , Leslie L Robison  2 , Melissa M Hudson  2   4 , Charles A Sklar  6 , Amar Gajjar  5
Affiliations

Central precocious puberty following the diagnosis and treatment of paediatric cancer and central nervous system tumours: presentation and long-term outcomes

Wassim Chemaitilly et al. Clin Endocrinol (Oxf). 2016 Mar.

Abstract

Objectives: To estimate the prevalence of central precocious puberty (CPP) after treatment for tumours and malignancies involving the central nervous system (CNS) and examine repercussions on growth and pubertal outcomes.

Design: Retrospective study of patients with tumours near and/or exposed to radiotherapy to the hypothalamus/pituitary axis (HPA).

Patients and measurements: Patients with CPP were evaluated at puberty onset, completion of GnRH agonist treatment (GnRHa) and last follow-up. Multivariable analysis was used to test associations between tumour location, sex, age at CPP, GnRHa duration and a diagnosis of CPP with final height <-2SD score (SDS), gonadotropin deficiency (LH/FSHD) and obesity, respectively.

Results: Eighty patients (47 females) had CPP and were followed for 11·4 ± 5·0 years (mean ± SD). The prevalence of CPP was 15·2% overall, 29·2% following HPA tumours and 6·6% after radiotherapy for non-HPA tumours. Height <-2SDS was more common at the last follow-up than at the puberty onset (21·4% vs 2·4%, P = 0·005). Obesity was more prevalent at the last follow-up than at the completion of GnRHa or the puberty onset (37·7%, 22·6% and 20·8%, respectively, P = 0·03). Longer duration of GnRHa was associated with increased odds of final height <-2SDS (OR = 2·1, 95% CI 1·0-4·3) and longer follow-up with obesity (OR = 1·3, 95% CI 1·1-1·6). LH/FSHD was diagnosed in 32·6%. There was no independent association between CPP and final height <-2SDS, and LH/FSHD and obesity in the subset of patients with HPA low-grade gliomas.

Conclusions: Patients with organic CPP experience an incomplete recovery of growth and a high prevalence of LH/FSHD and obesity. Early diagnosis and treatment of CPP may limit further deterioration of final height prospects.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None of the authors have conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Consort Diagram
Figure 2
Figure 2
Mean Height at Different Study Time Points Plotted on General Population Based Growth Charts for Males and Females
See this image and copyright information in PMC

References

    1. Ojeda SR, Lomniczi A, Mastronardi C, et al. Minireview: the neuroendocrine regulation of puberty: is the time ripe for a systems biology approach? Endocrinology. 2006;147(3):1166–1174. - PubMed
    1. Chemaitilly W, Trivin C, Adan L, et al. Central precocious puberty: clinical and laboratory features. Clin Endocrinol (Oxf) 2001;54(3):289–294. - PubMed
    1. Gan HW, Phipps K, Aquilina K, et al. Neuroendocrine morbidity after pediatric optic gliomas: a longitudinal analysis of 166 children over 30 years. J Clin Endocrinol Metab. 2015:jc20152028. - PubMed
    1. Brauner R, Czernichow P, Rappaport R. Precocious puberty after hypothalamic and pituitary irradiation in young children. N Engl J Med. 1984;311(14):920. - PubMed
    1. Constine LS, Woolf PD, Cann D, et al. Hypothalamic-pituitary dysfunction after radiation for brain tumors. N Engl J Med. 1993;328(2):87–94. - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources