Gilleland Marchak Jordan, Elchuri Swati V, Vangile Kristen, Wasilewski-Masker Karen, Mertens Ann C, Meacham Lillian R
Departments of *Pediatrics, Hematology/Oncology ‡Pediatrics, Endocrinology, Emory University School of Medicine †Aflac Cancer Center, Children's Healthcare of Atlanta, Atlanta, GA.
J Pediatr Hematol Oncol. 2015 Jul;37(5):368-72. doi: 10.1097/MPH.0000000000000349.
Research has established that childhood cancer treatments can place survivors at risk for reproductive health problems, yet little is known about pediatric survivors' perceptions of their risk for infertility and worry about future family planning. The purpose of this study was to explore factors that affect awareness of risk for and worry about infertility among female pediatric cancer survivors aged 10 to 21 (N=48) and their parents (N=41) following exposure to treatments associated with reproductive late effects. The majority of female childhood cancer survivors (71%) and their parents (95%) reported worry about infertility following gonadotoxic therapy. Cross-sectional data indicated that survivors' awareness of risk for and worry about infertility increase during adolescence, whereas parents' awareness of risk and worry generally remain constant throughout their daughters' development. Survivor worry about infertility was predicted by a variety of factors, yet parent worry about infertility was only associated with increased gonadotoxic radiation exposure. Overall, these findings reinforce the necessity of developmentally appropriate education about reproductive health risks and fertility preservation options across the continuum of pediatric oncology care from diagnosis to survivorship.
研究表明，儿童癌症治疗会使幸存者面临生殖健康问题的风险，但对于儿科癌症幸存者对不孕风险的认知以及对未来计划生育的担忧知之甚少。本研究的目的是探讨影响10至21岁女性儿科癌症幸存者（N = 48）及其父母（N = 41）在接受与生殖远期效应相关的治疗后，对不孕风险的认知和担忧的因素。大多数女性儿童癌症幸存者（71%）及其父母（95%）报告称，在接受性腺毒性治疗后担心不孕。横断面数据表明，幸存者对不孕风险的认知和担忧在青春期会增加，而父母对风险和担忧的认知在其女儿的整个成长过程中通常保持不变。幸存者对不孕的担忧由多种因素预测，但父母对不孕的担忧仅与性腺毒性辐射暴露增加有关。总体而言，这些发现强化了在从诊断到存活的整个儿科肿瘤护理连续过程中，开展关于生殖健康风险和生育力保存选择的适合不同发育阶段教育的必要性。
