Critical appraisal:Schmiegelow M, Lassen S, Poulsen HS, Schmiegelow K, Hertz H, Andersson AM, et al 2001

From Cancer Guidelines Wiki

Critical Appraisal

Article being appraised

Schmiegelow M, Lassen S, Poulsen HS, Schmiegelow K, Hertz H, Andersson AM, et al. Gonadal status in male survivors following childhood brain tumors. J Clin Endocrinol Metab 2001 Jun;86(6):2446-52 Available from: http://www.ncbi.nlm.nih.gov/pubmed/11397837.


Applicable clinical question

Key Facts

Study Design

case-control study

Study aims:

To assess the effect of radiation therapy (RT) and CT on gonadal function in a population-based follow-up study of males treated for a brain tumor in childhood.

Number of Patients:

30

N=13 patients treated with radiation and chemotherapy

N=17 patients treated with radiation only

N=347 healthy controls
Reported outcome(s):

inhibin B
gonadotrophins
testosterone
total testicular volume

Results of outcome(s):

inhibin B: 86pg/mL in RT-CT group, compared to 270pg/mL in RT only group and 215pg/mL in controls

gonadotrophins: no significant difference

testosterone: no significant difference between patients treated with RT 􏰊 CT, compared with patients treated with RT only, in median testosterone (12.8 vs. 14.7 nmol/L); however, both the RT 􏰊 CT group and the RT-only group had significantly lower testosterone lev- els, compared with our reference population (12.8 vs. 21.9 nmol/L; P 􏰌 0.001, and 14.7 vs. 21.9 nmol/L; P 􏰌 0.0003, respectively)

total testicular volume: no significant difference in median total testicular volume (27.0 vs. 40.0 mL; P 􏰌 0.16) in the RT- CT group, compared with the RT-only group, probably due to the small sample size.

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-3

Risk of bias
High risk of bias Comments:
Result of appraisal

Jutta's tick icon.png Included



Comments

- for a childhood brain tumor may affect the HP axis resulting in secondary hypogonadism, and adjuvant CT may have a deleterious affect upon the seminiferous epithelium of the testes leading to reduction in inhibin B and inhibin B/FSH ratio indicating primary gonadal damage i.e. inhibin B may be useful in these settings
- small numbers

Completed by

Dr Jessica Harris

Jutta's tick icon.png This appraisal has been completed.


Article
Schmiegelow M, Lassen S, Poulsen HS, Schmiegelow K, Hertz H, Andersson AM, et al. Gonadal status in male survivors following childhood brain tumors. J Clin Endocrinol Metab 2001 Jun;86(6):2446-52 Available from: http://www.ncbi.nlm.nih.gov/pubmed/11397837.
Assigned to
User:Rita.upreti
Topic area
Guidelines:COSA:Cancer fertility preservation guidelines/Impact of cancer on fertility
Clinical question
Form
Form:Critical appraisal


Section below only relevant for Cancer Council Project Officer

Edit appraisal assignment