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. 2010 Jan 10;28(2):332-9.
doi: 10.1200/JCO.2009.24.9037. Epub 2009 Nov 30.

Fertility of male survivors of childhood cancer: a report from the Childhood Cancer Survivor Study

Daniel M Green  1 , Toana Kawashima, Marilyn Stovall, Wendy Leisenring, Charles A Sklar, Ann C Mertens, Sarah S Donaldson, Julianne Byrne, Leslie L Robison
Affiliations

Fertility of male survivors of childhood cancer: a report from the Childhood Cancer Survivor Study

Daniel M Green et al. J Clin Oncol. .

Abstract

Purpose: This study was undertaken to determine the effect of treatment for childhood cancer on male fertility.

Patients and methods: We reviewed the fertility of male Childhood Cancer Survivor Study survivor and sibling cohorts who completed a questionnaire. We abstracted the chemotherapeutic agents administered, the cumulative dose of drug administered for selected drugs, and the doses and volumes of all radiation therapy from medical records. Risk factors for siring a pregnancy were evaluated using Cox proportional hazards models.

Results: The 6,224 survivors age 15 to 44 years who were not surgically sterile were less likely to sire a pregnancy than siblings (hazard ratio [HR], 0.56; 95% CI, -0.49 to 0.63). Among survivors, the HR of siring a pregnancy was decreased by radiation therapy of more than 7.5 Gy to the testes (HR, 0.12; 95% CI, -0.02 to 0.64), higher cumulative alkylating agent dose (AAD) score or treatment with cyclophosphamide (third tertile HR, 0.42; 95% CI, -0.31 to 0.57) or procarbazine (second tertile HR, 0.48; 95% CI, -0.26 to 0.87; third tertile HR, 0.17; 95% CI, -0.07 to 0.41). Compared with siblings, the HR for ever siring a pregnancy for survivors who had an AAD score = 0, a hypothalamic/pituitary radiation dose = 0 Gy, and a testes radiation dose = 0 Gy was 0.91 (95% CI, 0.73 to 1.14; P = .41).

Conclusion: This large study identified risk factors for decreased fertility that may be used for counseling male cancer patients.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Flowchart of cohort subgroups for male fertility analysis. Long-term follow-up study (LTFU). (*) Includes refusals (n = 1,971) and insufficient data to define participation (n = 81).
Fig 2.
Fig 2.
Relationship between summed alkylating agent dose score and the relative risk for siring a pregnancy. (*) Relative risk is adjusted for age at diagnosis, race/ethnicity, marital status, educational attainment, nonalkylating chemotherapy drugs, hypothalamic/pituitary radiation dose, and testicular radiation dose. (†) Referent group = 0 score.
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References

    1. Ries LAG, Melbert D, Krapcho M, et al., editors. Bethesda, MD: National Cancer Institute; 2008. SEER Cancer Statistics Review: 1975-2005.
    1. Oosterhuis BE, Goodwin T, Kiernan M, et al. Concerns about infertility risks among pediatric oncology patients and their parents. Pediatr Blood Cancer. 2008;50:85–89. - PubMed
    1. Zebrack BJ, Casillas J, Nohr L, et al. Fertility issues for young adult survivors of childhood cancer. Psychooncology. 2004;13:689–699. - PubMed
    1. Sklar C. Reproductive physiology and treatment-related loss of sex hormone production. Med Pediatr Oncol. 1999;33:2–8. - PubMed
    1. Sklar CA, Constine LS. Chronic neuroendocrinological sequelae of radiation therapy. Int J Radiat Oncol Biol Phys. 1995;31:1113–1121. - PubMed

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