Ovarian failure following abdominal irradiation in childhood

Abstract

Ovarian function was studied in 18 female patients treated for abdominal tumours during childhood. All received abdominal radiotherapy as part of their treatment and were studied between 1 and 26 years after irradiation. The serum gonadotrophins and oestradiol levels were consistent with ovarian failure in each case but there was a disproportionate elevation in serum follicle stimulating hormone (FSH) when compared to serum luteinizing hormone (LH) in 16. In 2 patients, the radiotherapeutic field extended downwards only as far as the sacral promontory. However, these 2 girls show similar evidence of ovarian failure to that in the other 16.

PIP: 18 female patients who had received treatment for abdominal lesions in childhood were studied for ovarian function. All had had abdominal surgery and irradiation and 7 had chemotherapy. The dose of irradiation ranged from 2000 to 3000 rad over 25-44 days. Serum follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were measured by double antibody radioimmunoassay using Medical Research Council standard 69/104, and serum estradiol was measured by radioimmunoassay. 12 of the patients were 13-years-old or over and none was menstruating. The basal serum FSH and LH levels were elevated in all 12. In the 6 patients below age 13, the serum FSH concentration was raised, but the serum LH was elevated in only 3 of the above. The serum LH levels were significantly higher (p less than .02) in the patients aged over 11 years or less. The probable cause of ovarian failure in these patients is abdominal irradiation. A similar hormonal pattern to the other 16 cases was seen in the 2 patients who had received abdominal irradiation with a field extending only as far as the sacral promontory.