Childhood cancer survivors (CCS) are at an increased risk of endocrine disorders. Disorders of the hypothalamic-pituitary-gonadal (HPG) axis are a particular concern because of their impact on pubertal development and future fertility and may be of central (hypothalamic or pituitary damage) or primary (gonadal) origin. Hypogonadism may present as pubertal disorders during adolescence and subsequent infertility in adulthood but should be anticipated to ensure appropriate surveillance is in place to address these issues at an appropriate age. Those at risk of HPG axis dysfunction include those with tumours primarily affecting the hypothalamus, pituitary or gonads themselves or due to their treatment with surgery, radiotherapy and chemotherapy. CCS who have had cranial irradiation of more than 30 Gy are at risk of gonadotrophin deficiency. Those who have had gonadotoxic chemotherapy, especially alkylating agents or radiotherapy to the gonads are at risk of primary gonadal failure. HSCT survivors who have had chemotherapy and total body irradiation are at risk of primary gonadal failure but may also have gonadotrophin deficiency. Understanding those at risk is essential to appropriate counselling and long-term follow-up. This chapter gives an overview on the impact of childhood cancer and its treatment on puberty, gonadal function and fertility in childhood cancer survivors.

中文翻译：

---

在男孩和女孩中，儿童期癌症及其治疗对青春期及随后的下丘脑垂体和性腺功能的影响。

儿童癌症幸存者（CCS）患内分泌疾病的风险增加。下丘脑-垂体-性腺（HPG）轴的疾病特别受关注，因为它们会影响青春期发育和未来的生育能力，并且可能是中央性（下丘脑或垂体损害）或原发性（性腺）起源。性腺功能减退症可能在青春期以及成年后的不孕症中表现为青春期疾病，但是应该预料到要确保进行适当的监测以在适当的年龄解决这些问题。有HPG轴功能障碍风险的人包括那些肿瘤主要影响下丘脑，垂体或性腺本身或由于手术，放疗和化学疗法而受到治疗的人。颅内照射超过30 Gy的CCS有发生促性腺激素缺乏症的风险。接受过性腺毒性化疗，尤其是烷基化剂或性腺放疗的患者，有原发性腺功能衰竭的风险。曾接受化学疗法和全身照射的HSCT幸存者有原发性腺功能衰竭的风险，但也可能患有促性腺激素缺乏症。了解危险人群对于适当的咨询和长期随访至关重要。本章概述了儿童期癌症的影响及其治疗对儿童期癌症幸存者的青春期，性腺功能和生育能力的影响。了解危险人群对于适当的咨询和长期随访至关重要。本章概述了儿童期癌症的影响及其治疗对儿童期癌症幸存者的青春期，性腺功能和生育能力的影响。了解危险人群对于适当的咨询和长期随访至关重要。本章概述了儿童期癌症的影响及其治疗对儿童期癌症幸存者的青春期，性腺功能和生育能力的影响。