Ovarian function in female survivors after multimodal Ewing sarcoma therapy. Issue 2 (15th November 2014)

• Record Type: Journal Article
• Authors: Raciborska, Anna; Bilska, Katarzyna; Filipp, Ewa; Drabko, Katarzyna; Rogowska, Elżbieta; Chaber, Radosław; Pogorzała, Monika; Połczyńska, Katarzyna; Adrianowska, Natalia; Rodriguez‐Galindo, Carlos; Maciejewski, Tomasz
• Is Part Of: Pediatric blood & cancer. Volume 62:Issue 2(2015:Feb.)
• Page Start: 341
• Page End: 345
• Publication Date: 2014-11-15
• Subjects: Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.25304
• Languages: English
• ISSNs: 1545-5009

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="pbc25304-sec-0001" sec-type="section"> <title>Background</title> <p>With advances in cancer care, more young women with Ewing sarcoma (ES) survive after treatment. Thus, we sought to analyze the ovarian function in prepubertal, pubertal and postpubertal females and young women receiving multimodal therapy for ES, and to identify patients at risk of infertility on whom fertility preservation would be indicated.</p> </sec> <sec id="pbc25304-sec-0002" sec-type="section"> <title>Procedures</title> <p>Twenty‐seven female survivors of ES were included in this retrospective multiinstitutional study. Patients were classified into four groups according to the treatment received: chemotherapy (CHT) without pelvic radiation (pRT), chemotherapy and pRT, CHT and autologous hematopoietic cell stem rescue (aHSCT) without pRT, and CHT + pRT + aHSCT. The ovarian function and fertility outcomes were analyzed.</p> </sec> <sec id="pbc25304-sec-0003" sec-type="section"> <title>Results</title> <p>At a median follow‐up of 5.7 years from diagnosis, and at median age at follow‐up of 16.3 years, 67% of the survivors had premature ovarian insufficiency, including all patients receiving pelvic RT and 87.5% of patients who underwent aHSCT, independent of chemoprotection. Thirty‐seven percent of patients had a clinical syndrome of premature menopause. The relative risk (RR) of premature ovarian insufficiency of a survivor was 3.9 (p 0.03) for pRT, and 2.4 (p 0.07) for aHSCT. On multivariate analysis, radiation therapy was a significant predictor of higher risk of premature ovarian insufficiency over chemotherapy alone.</p> </sec> <sec id="pbc25304-sec-0004" sec-type="section"> <title>Conclusions</title> <p>A large proportion of women receiving multimodal therapy for ES develop premature ovarian insufficiency. Patients and guardians should be informed about the reproductive potential and strategies for preservation of ovarian function should be considered individually. Pediatr Blood Cancer 2015;62:341–345. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>