Leydig cell failure with testicular radiation doses

Abstract:

OBJECTIVE:Testosterone replacement is generally considered likely to be required only at testicular radiation doses in excess of 20Gy. Long-term data are not available for patients receiving 9-14.4Gy as part of Total Body Irradiation in childhood. DESIGN:Retrospective cohort study. DATA COLLECTION:notes review, laboratory results, prescription of testosterone. PATIENTS:Forty-two of 96 boys who received Total Body Irradiation (9-14.4Gy) and Haematopoietic Stem Cell Transplantation for childhood leukaemia at Great Ormond Street Hospital between 1981-2011 and survived >5 years. MEASUREMENTS:The serum concentrations of testosterone and gonadotrophins and the prescription of testosterone were recorded. RESULTS:Of the 42 boys included, 37 (88%) entered puberty spontaneously and 5 required induction. Median length of follow-up was 19.4 years (range 5-33.1). At last follow-up, 23 of the 37 (62%) with spontaneous puberty were receiving testosterone replacement and 4 of the 5 (80%) with induced puberty. CONCLUSION:This study with the benefit of long follow-up indicates that Leydig cell failure occurs with radiation doses <20Gy. It may occur many years after irradiation and mandates long-term screening for hypogonadism.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Taneja S,Rao A,Nussey S,Leiper A

doi

10.1111/cen.14059

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

624-632

issue

5

eissn

0300-0664

issn

1365-2265

journal_volume

91

pub_type

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