儿童癌症治疗可能导致长期影响。本横断面研究评估了男性儿童癌症幸存者（CCS）在成年里程碑上的情况。研究人群包括252名6至42年幸存的男性CCS，诊断年龄为0至17岁，就读于赫尔辛基儿童医院（1964-2000年）。从芬兰国家登记册中随机选择与性别、年龄和居住地区匹配的人群对照。比较了CCS在离开父母家、婚姻状况、后代和领养方面的数据与人群对照组之间的差异。我们分析了化疗和放射线照射以及青春期发育期间睾丸功能障碍（曾经非睾丸素替代血清卵泡刺激素水平>15 IU/L，黄体生成素水平>15 IU/L，睾酮<2 ng/mL（5 nmol/L），需要睾酮替代治疗，或青春期末睾丸体积<12 mL）对长期社交结果的影响。CCS离开父母家的频率与人群对照组相当（97.8% vs. 98.5%，p = .45）。CCS结婚或在婚姻关系中生活的可能性较小（46.4% vs. 57.5%，p < .001），特别是在年幼时（<4岁）被诊断出的情况下。在那些已婚的人中，离婚的可能性在CCS和人群对照组之间相似（27.4% vs. 23.8%，p = .41）。幸存者生育子女的可能性较低（38.5% vs. 59.1%，p < .001），领养的可能性较高（2% vs. 0.4%，p = .015）。较低的生育能力与造血干细胞治疗、睾丸放射线剂量>6 Gy、青春期睾丸功能障碍迹象（非睾丸素替代血清卵泡刺激素水平>15 IU/L，黄体生成素水平>15 IU/L，睾酮<2 ng/mL（5 nmol/L），或青春期末睾丸体积<12 mL）或青春期后无精症有关。本研究强调了监测青春期睾丸功能以估计未来生育能力的重要性。如果在青春期随访中没有发现功能障碍迹象，生育能力与人群对照组相当。睾丸放射线剂量>6 Gy似乎是降低生育能力的最强风险因素。接受密集治疗，包括造血干细胞治疗、睾丸放射线剂量>6 Gy和睾丸功能障碍迹象，是导致生育率降低的重要风险因素。密集治疗和睾丸功能障碍本身不会同样影响成年后心理社交里程碑；在非常幼年时诊断为癌症（<4岁）会降低结婚的可能性。本研究强调了监测青春期发育的重要性，强调睾丸功能，而不仅仅是精液分析，以估计男性儿童癌症幸存者未来的生育能力。 © 2023 The Authors. Cancer由Wiley Periodicals LLC代表美国癌症协会出版。

Childhood cancer therapy may cause long-term effects. This cross-sectional study evaluated adulthood milestones in male childhood cancer survivors (CCS).The study population comprised 252 male CCS with 6 to 42 years of survival diagnosed at the Children's Hospital in Helsinki (1964-2000) at the age of 0 to 17 years. Sex-, age-, and area of residence-matched population controls were randomly selected from the Finnish national registries. Data on moving away from the parental home, marital status, offspring, and adoption in CCS were compared with the population controls. We analyzed the influence of chemotherapy and radiation exposures and testicular dysfunction (ever nontestosterone-substituted serum follicle stimulating hormone >15 IU/L, luteinizing hormone >15 IU/L, testosterone <2 ng/mL (5 nmol/L), need of testosterone replacement therapy, or testicular volume <12 mL at the end of puberty) during pubertal maturation on long-term social outcomes.CCS moved away from their parental home as frequently as population controls (97.8% vs. 98.5%, p = .45). CCS were less likely to marry or live in a registered relationship (46.4% vs. 57.5%, p < .001), especially when diagnosed at a young age (<4 years). Among those married, the probability of divorce was similar between CCS and population controls (27.4% vs. 23.8%, p = .41). Survivors were less likely to sire a child (38.5% vs. 59.1%, p < .001) and more likely to adopt (2% vs. 0.4%, p = .015). Lower probability of paternity was associated with hematopoietic stem cell therapy, testicular radiation dose >6 Gy, pubertal signs of testicular dysfunction (nontestosterone-substituted serum follicle stimulating hormone >15 IU/L, luteinizing hormone  >15 IU/L, testosterone <2 ng/mL (5 nmol/L), or need of testosterone replacement therapy during puberty, or testicular volume <12 mL at the end of puberty) or azoospermia after puberty.This study emphasizes the value of pubertal monitoring of testicular function to estimate future probability of paternity. If no signs of dysfunction occurred during pubertal follow-up, paternity was comparable to population controls. Testicular radiation dose >6 Gy appeared to be the strongest risk factor for decreased paternity.Treatment with intensive therapies, including hematopoietic stem cell therapy, testicular radiation dose >6 Gy, and signs of testicular dysfunction, during puberty are important risk factors for lower rates of fertility. Intensive therapies and testicular dysfunction itself do not similarly hamper psychosocial milestones in adulthood; cancer diagnosis at a very young age (<4 years) lower the probability of marriage. This study accentuates the importance of monitoring of pubertal development, emphasizing on testicular function, not only sperm analysis, to estimate future fertility among male childhood cancer survivors.© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.