生育能力减退是儿童癌症幸存者中的一个重要晚期并发症。本研究旨在阐明对于患有生育能力减退的癌症幸存者来说，雌激素替代疗法（ERT）的优势和局限。17名癌症幸存者被分为两组：性腺性生育能力减退（GH）组（n = 8）和中枢性生育能力减退（CH）组（n = 9）。利用Pearson相关系数研究了癌症治疗对终身身高、骨密度和子宫发育的影响。 GH组中有7例患者患有血液系统恶性肿瘤，并且所有患者在骨髓移植前都接受了全身照射。GH组显示出疾病治疗开始时的年龄与终身身高（p < 0.05，R = 0.712）以及ERT后子宫尺寸（p < 0.05，R = 0.775）之间存在显著正相关。CH组中所有癌症幸存者都患有脑肿瘤，并且其中7人接受了化疗。疾病治疗开始时的年龄与终身身高（p = 0.09，R = 0.598）或子宫尺寸（p = 0.07，R = -0.669）之间存在趋势性的正负相关。在接受生长激素治疗的6名CH患者中，ERT开始时的年龄与终身身高（p = 0.07，R = -0.769）或骨密度（p = 0.18，R = -0.626）之间存在负相关趋势。尽管接受了ERT，两组中的5例癌症幸存者出现了骨质疏松症。 针对性的个体化管理策略对于降低患有生育能力减退的癌症幸存者的长期并发症至关重要，考虑了癌症治疗的类型和时间。© 2023. 作者（根据日本临床肿瘤学会的独家许可）

Hypogonadism is a significant late complication in childhood cancer survivors (CCS). The aim of this study was to elucidate the advantages and limitations of estrogen replacement therapy (ERT) for CCS with hypogonadism.Seventeen CCS were divided into two groups: gonadal hypogonadism (GH) group (n = 8) and central hypogonadism (CH) group (n = 9). Pearson correlation coefficients were used to investigate the impact of cancer management on final height, bone density, and uterine development.Seven of GH group had hematologic malignancies, and all of them underwent total body irradiation before bone marrow transplantation. The GH group showed significant positive correlations between the onset age of disease treatment and final height (p < 0.05, R = 0.712) and uterine size following ERT (p < 0.05, R = 0.775). All CCS in the CH group had brain tumors, and seven of them received chemotherapy. There were trends towards positive and negative correlations between the onset age of disease treatment and final height (p = 0.09, R = 0.598) or uterine size (p = 0.07, R = - 0.669), respectively. A negative correlation trend was observed between the age at ERT initiation and final height (p = 0.07, R = - 0.769) or bone density (p = 0.18, R = - 0.626) in six CH patients who received growth hormone therapy. Five CCS in both groups experienced osteoporosis, despite receiving ERT.Individualized management strategies beyond ERT are essential to reduce long-term complications in CCS with hypogonadism, considering the type and timing of cancer treatment.© 2023. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.