Pubertal development in children treated for nephroblastoma.

Recent improvements in the treatment of children with nephroblastoma have led to an increase in the disease-free survival rate. The late effect of treatment on long-term survivors requires assessment to determine whether avoidable iatrogenic disorders are appearing. The onset of puberty is one measurement of physical development and has been used in the study to assess the progress of 16 children over the age of 12 yr who were treated for nephroblastoma. The method consisted of the measuring body height, weight and testicular size, estimating serum levels of luteinizing hormone, follicular stimulating hormone and testosterone, recording the age at menarche, and staging of pubic hair and breast development. There was evidence of complete ovarian suppression in 3 out of 10 girls and of delayed and testicular function in 1 out of 6 boys. Analysis of the treatment received by the children implicated radiotherapy as the responsible factor causing gonadal suppression.