Moss Jared L, Choi Andrew Wonho, Fitzgerald Keeter Mary Kate, Brannigan Robert E
Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Fertil Steril. 2016 Feb;105(2):267-73. doi: 10.1016/j.fertnstert.2015.12.002. Epub 2015 Dec 17.
Until the 1960s, few adolescents and young adults (AYAs) survived their initial cancer diagnoses. Now, ∼12,400 AYA patients are diagnosed with cancer each year, and almost 80% will now achieve a long-term cure. This dramatic improvement in survival is primarily due to multimodal treatments and combined chemotherapeutic regimens. Unfortunately, the increase in survival is often accompanied by treatment-related toxicities due to chemotherapy, radiation therapy, and surgical procedures. Despite guidelines published by the American Society of Clinical Oncology and numerous other professional organizations, high percentages of male AYA oncology patients are not properly counseled regarding their fertility preservation options before cancer treatment. Although administering fertility preservation care to adolescent males can be challenging in many ways, numerous studies show that this care can be delivered with high degrees of success and high levels of patient and parent satisfaction. The key to this success at many institutions has been the implementation of formalized integrated fertility preservation programs with infrastructure geared toward the delivery of comprehensive expedited care.
直到20世纪60年代,很少有青少年和青年(AYA)在初次被诊断患有癌症后存活下来。如今,每年约有12400名AYA患者被诊断患有癌症,而且现在几乎80%的患者都能实现长期治愈。生存率的这一显著提高主要归功于多模式治疗和联合化疗方案。不幸的是,生存率的提高往往伴随着化疗、放疗和外科手术带来的与治疗相关的毒性反应。尽管美国临床肿瘤学会和许多其他专业组织发布了相关指南,但仍有很高比例的男性AYA肿瘤患者在癌症治疗前未得到关于生育力保存选择的适当咨询。尽管为青春期男性提供生育力保存护理在很多方面具有挑战性,但大量研究表明,这种护理能够取得高度成功,患者及其父母的满意度也很高。许多机构取得这一成功的关键在于实施了正式的综合生育力保存项目,其基础设施旨在提供全面的快速护理。