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. 2013 Dec;139(12):2071-8.
doi: 10.1007/s00432-013-1527-9. Epub 2013 Oct 2.

Impact of chemotherapy and radiotherapy in childhood on fertility in adulthood: the FeCt-survey of childhood cancer survivors in Germany

Simone Reinmuth  1 , Cynthia Hohmann, Rosa Rendtorff, Magdalena Balcerek, Steve Holzhausen, Andreas Müller, Günter Henze, Thomas Keil, Anja Borgmann-Staudt
Affiliations

Impact of chemotherapy and radiotherapy in childhood on fertility in adulthood: the FeCt-survey of childhood cancer survivors in Germany

Simone Reinmuth et al. J Cancer Res Clin Oncol. 2013 Dec.

Abstract

Purpose: Improved treatment for childhood cancer has led to better survival rates of 83 % today. However, long-term side effects including infertility of pediatric patients receiving oncologic treatment remain unclear. We examined the association of chemotherapy and radiotherapy with infertility in survivors of pediatric cancer.

Methods: A questionnaire on fertility was sent to adult survivors listed in the German Childhood Cancer Registry. Fertility status was defined based on information on attempts to conceive, pregnancies, births, menstrual cycle and previous fertility test results.

Results: Therapeutic data were obtained from treatment optimization trials. We included 618 childhood cancer survivors (384 women) who reported information allowing us to classify their current fertility status as 'fertile/probably fertile' or 'probably infertile'. Thirty-one percent of 83 female and 29 % of 117 male survivors reported infertility based on previous fertility tests. 'Probably infertile' adult survivors were more likely to have received pelvic radiotherapy (women: adjusted OR 20.24, 95 % CI 4.69-87.29; men: 12.22; 1.18-126.70) than those who were 'fertile/probably fertile'. Etoposide, particularly ≥5,000 mg/m(2) in women, and carboplatin and/or cisplatin in both sexes seemed to have independent risk potential for infertility. Similarly, cancer treatment during or post-puberty compared to treatment before puberty showed a trend toward increased infertility, particularly in male survivors.

Conclusions: Patients and families need to be informed about fertility-preserving measures prior to and also after chemotherapy and radiotherapy.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Flowchart showing the inclusion of the FeCt study participants for the current analyses. GCCR German Childhood Cancer Registry, TOT treatment optimization trials
Fig. 2
Fig. 2
Distribution of pediatric oncological diagnoses among former childhood cancer patients who participated in the nationwide survey on fertility in 2008 (n = 2,754) in comparison with the distribution of oncological diagnoses among patients who did not respond to the study (n = 1,810), based on information of the German Childhood Cancer Registry
See this image and copyright information in PMC

References

    1. Balcerek M, Reinmuth S, Hohmann C, Keil T, Borgmann-Staudt A (2012) Suspected infertility after treatment for leukemia an solid tumors in childhood and adolescence. Dtsch Arztebl Int 109:126–131 - PMC - PubMed
    1. Bogdanovic R, Banicevic M, Cvoric A (1990) Pituitary-gonadal function in women following cyclophosphamide treatment for childhood nephrotic syndrome: long-term follow-up study. Pediatr Nephrol 4:455–458 - PubMed
    1. Bramswig JH, Heimes U, Heiermann E, Schlegel W, Nieschlag E, Schellong G (1990) The effects of different cumulative doses of chemotherapy on testicular function. Results in 75 patients treated for Hodgkin’s disease during childhood or adolescence. Cancer 65:1298–1302 - PubMed
    1. Byrne J, Mulvihill JJ, Myers MH, Connelly RR, Naughton MD, Krauss MR, Steinhorn SC, Hassinger DD, Austin DF, Bragg K, Holmes GF, Holmes FF, Latourette HB, Weyer PJ, Meigs W, Teta J, Cook JW, Strong LC (1987) Effects of treatment on fertility in long-term survivors of childhood or adolescent cancer. N Engl J Med 317:1315–1321 - PubMed
    1. Clemm C, Liedl B, Zimmermann F (2003) Gonadotoxizität von Chemo- und Strahlentherapie, 3rd edn. Zuckschwerdt, Munich

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