调查结果表明：青少年生殖保护（SPARE）研究——向癌症青少年传递生育力保护信息方面的性别差异。
Results from the survey for preservation of adolescent reproduction (SPARE) study: gender disparity in delivery of fertility preservation message to adolescents with cancer.
机构信息
Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.
出版信息
J Assist Reprod Genet. 2011 Mar;28(3):269-77. doi: 10.1007/s10815-010-9504-6. Epub 2010 Nov 26.
PURPOSE
Diminished reproductive capacity is a devastating consequence of life-sparing therapies for childhood malignancy. In 2006, the American Society of Clinical Oncology (ASCO) published fertility preservation recommendations (ASCOR) emphasizing the importance of early discussion and intervention for fertility preservation strategies. Using the Survey for Preservation of Adolescent REproduction (SPARE), we sought to determine fertility preservation attitudes and practice patterns post-ASCOR from pediatric oncology specialists nationwide.
MATERIALS AND METHODS
The SPARE survey consists of 22 questions assessing pediatric oncology specialists' attitudes and practice patterns toward fertility preservation. Broad perspectives on fertility preservation, including a willingness to discuss fertility, knowledge of current fertility preservation methods and awareness of ASCOR, were assessed.
RESULTS
The majority of respondents acknowledged that fertility threats are a major concern for them and agreed that all pubertal cancer patients should be offered a fertility consultation, but only 46% reported they refer male pubertal cancer patients to a fertility specialist prior to cancer treatment >50% of the time, and only 12% reported they refer female pubertal cancer patients to a fertility specialist prior to cancer treatment > 50% of the time. While 44% of respondents were familiar with the 2006 ASCOR, only 39% of those utilized them to guide decision-making in greater than half of their patients.
CONCLUSION
Our study demonstrates pediatric oncologists' motivation to preserve fertility in pediatric cancer patients; however, barriers to both gamete cryopreservation and referral to fertility specialists persist. Female pubertal patients are referred to fertility preservation specialists with much less frequency than are male pubertal patients, highlighting a disparity.
目的
对于儿童恶性肿瘤的挽救生命的治疗，生殖能力降低是毁灭性的后果。2006 年，美国临床肿瘤学会（ASCO）发布了生育力保存建议（ASCOR），强调了早期讨论和干预生育力保存策略的重要性。我们使用青少年生殖保存调查（SPARE），旨在从全国儿科肿瘤专家中确定 ASCOR 后的生育力保存态度和实践模式。
材料和方法
SPARE 调查包括 22 个问题，评估儿科肿瘤专家对生育力保存的态度和实践模式。广泛的生育力保存观点，包括讨论生育力的意愿、了解当前生育力保存方法和对 ASCOR 的认识，都得到了评估。
结果
大多数受访者承认生育威胁是他们的主要关注点，并同意应向所有青春期癌症患者提供生育咨询，但只有 46%的人报告说，他们在癌症治疗前 >50%的时间将男性青春期癌症患者转介给生育专家，只有 12%的人报告说，他们在癌症治疗前 >50%的时间将女性青春期癌症患者转介给生育专家。虽然 44%的受访者熟悉 2006 年的 ASCOR，但只有 39%的人利用它们来指导超过一半的患者的决策。
结论
我们的研究表明儿科肿瘤学家有动机在儿科癌症患者中保留生育力；然而，配子冷冻保存和向生育专家转介的障碍仍然存在。青春期女性患者被转介到生育力保存专家的频率远低于青春期男性患者，这突显了一种差异。
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