{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T09:34:05Z","timestamp":1774085645919,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,10,18]],"date-time":"2014-10-18T00:00:00Z","timestamp":1413590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"crossref","award":["P30-CA21765"],"award-info":[{"award-number":["P30-CA21765"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Noyes Brain Tumor Foundation"},{"name":"Musicians Against Childhood Cancer (MACC)"},{"name":"American Lebanese Syrian Associated Charities (ALSAC)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Female survivors of central nervous system (CNS) tumors are at an increased risk for gonadal damage and variations in the timing of puberty following radiotherapy and alkylating agent\u2010based chemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Clinical and laboratory data were obtained from 30 evaluable female patients with newly diagnosed embryonal CNS tumors treated on a prospective protocol (SJMB 96) at St. Jude Children's Research Hospital (SJCRH). Pubertal development was evaluated by Tanner staging. Primary ovarian insufficiency (POI) was determined by Tanner staging and FSH level. Females with Tanner stage I\u2013II and FSH\u2009&gt;\u200915\u2009mIU\/ml, or Tanner stage III\u2013V, FSH\u2009&gt;\u200925\u2009mIU\/ml and FSH greater than LH were defined to have ovarian insufficiency. Recovery of ovarian function was defined as normalization of FSH without therapeutic intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median length of follow\u2010up post completion of therapy was 7.2 years (4.0\u201310.8 years). The cumulative incidence of pubertal onset was 75.6% by the age of 13. Precocious puberty was observed in 11.1% and delayed puberty in 11.8%. The cumulative incidence of POI was 82.8%, though recovery was observed in 38.5%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment for primary CNS embryonal tumors may cause variations in the timing of pubertal development, impacting physical and psychosocial development. Female survivors are at risk for POI, a subset of whom will recover function over time. Further refinement of therapies is needed in order to reduce late ovarian insufficiency. Pediatr Blood Cancer 2015;62:329\u2013334. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.25274","type":"journal-article","created":{"date-parts":[[2014,10,18]],"date-time":"2014-10-18T15:10:14Z","timestamp":1413645014000},"page":"329-334","source":"Crossref","is-referenced-by-count":22,"title":["Pubertal development and primary ovarian insufficiency in female survivors of embryonal brain tumors following risk\u2010adapted craniospinal irradiation and adjuvant chemotherapy"],"prefix":"10.1002","volume":"62","author":[{"given":"Mariko","family":"DeWire","sequence":"first","affiliation":[{"name":"Division of Oncology Cincinnati Children's Hospital Medical Center Cincinnati Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel M.","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital Memphis 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