Utility of pediatric female fertility preservation discussions following pelvic radiation
While many childhood cancers are curable with therapy, adverse consequences in fertility exist. We sought to assess the number of female patients with pelvic tumors receiving radiation therapy, and the proportion that undergo measures for fertility preservation (FP).
A total of 53 female patients treated with pelvic tumors from 2000 to 2016 were retrospectively identified.
19 (34%) of these patients underwent pelvic radiation therapy (pXRT). Three of the patients received pXRT for palliative treatment. Of the 19 female patients receiving pXRT, six (31%) were prepubertal and 13 (68%) were postpubertal. Three patients (16%) had documentation of a discussion of FP measures prior to pXRT. One was prepubertal and the others were post-pubertal. Six patients (32%) were evaluated by endocrinology after radiation therapy, diagnosed with ovarian failure, and placed on hormone therapy. Current guidelines recommend discussion of FP in pre-and postpubertal patients with cancer. This 16-year retrospective review of female patients that underwent pXRT for pelvic tumors demonstrated < 17% of patients have documentation of a discussion of FP measures.
Female pediatric patients who underwent chemotherapy and pXRT suffer a high rate of premature ovarian failure, high morbidity and mortality as well as low rates of documented FP discussions. Based on these findings we have established a multi-disciplinary fertility preservation team available for consultation and a protocol for discussing and documenting the impact of pXRT, along with other treatments, on fertility.
Level of evidence
KeywordsPelvic radiation Fertility preservation Chemotherapy Ovarian function Pelvic tumor
The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
Study conception and design: ASP, JMF, and SRS. Acquisition of data: RMR and ASP. Analysis and interpretation of data: RMR, SDS, JMF and SRS. Drafting of manuscript: RMR and SRS. Critical revision of manuscript: RMR, SDS and SRS.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest. The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
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