Primary gonadal dysfunction after oncological treatment in a cohort of childhood medulloblastoma survivors

Luminita Cima; Marina Iliescu; Raluca Stan; Diana Puscasu; Iustina Grosu; Dumitrache Sabina Maria; Mihaela Tarna; Codruta Comsa; Oana Iaru; Monica Dragomir; Barbu Carmen Gabriela; Simona Fica

doi:10.1530/endoabs.110.EP1336

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Endocrine Abstracts (2025) 110 EP1336 | DOI: 10.1530/endoabs.110.EP1336

ECEESPE2025 ePoster Presentations Reproductive and Developmental Endocrinology (128 abstracts)

Primary gonadal dysfunction after oncological treatment in a cohort of childhood medulloblastoma survivors

Luminita Cima ¹ , Marina Iliescu ¹ , Raluca Stan ¹ , Diana Puscasu ¹ , Iustina Grosu ¹ , Sabina Maria Dumitrache ¹ , Mihaela Tarna ¹ , Codruta Comsa ² , Oana Iaru ² , Monica Dragomir ² , Carmen Gabriela Barbu ¹ & Simona Fica ¹

Author affiliations

¹Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Endocrinology, Bucharest, Romania; ²Oncologic Institute, Bucharest, Romania

JOINT3955

Background: Medulloblastoma is a cerebellar tumour that is usually diagnosed during childhood. Since the 5-year survival rate has risen, due to new therapeutic approaches, a high proportion of survivors develop late endocrine complications. These endocrinopathies may consist of hypothalamic–pituitary and growth disorders, obesity and metabolic syndrome, but also primary gonadal dysfunction. Gonadal insufficiency and infertility may impact the physical status and quality of life of these young patients. Therefore, we aimed to evaluate primary gonadal insufficiency in 31 subjects diagnosed with medulloblastoma that were treated with cranial and spinal radiotherapy apart from chemotherapy.

Material and Methods: We performed anamnesis, physical examination and hormonal profile in 31 survivors of childhood medulloblastoma that were evaluated in our clinic for long-term endocrine complications, median age at diagnosis 6 years (IQR 10), median follow-up length 31 month (IQR 35). Primary gonadal impairment was defined by any of the following: delayed/arrested puberty, primary/secondary amenorrhea, irregular menses, FSH >25 mIU/ml, low estradiol, low AMH.

Results: Primary gonadal dysfunction was present in 9 patients (29%) and occurred at a median time of 13 months (IQR 40). Our study showed a statistically significant correlation between primary gonadal dysfunction and underweight status (P = 0.005) and the age at diagnosis and treatment initiation (P = 0.038), respectively. There was no correlation between gonadal impairment and obesity, hypothyroidism, treatment protocol.

Conclusion: Our study demonstrated a high prevalence of primary gonadal insufficiency in survivors of childhood medulloblastoma that usually present with hypothalamic–pituitary damage as a result of radiotherapy. Therefore, we recommend counselling patients with a diagnosis of medulloblastoma with regards to potential damage to the gonads and thereby offer fertility preservation procedures in selected patients.