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儿童、青少年和青年期癌症女性幸存者卵巢早衰监测建议:国际儿童癌症长期效应指南协调小组与PanCareSurFup联盟合作发布的报告

Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With the PanCareSurFup Consortium.

作者信息

van Dorp Wendy, Mulder Renée L, Kremer Leontien C M, Hudson Melissa M, van den Heuvel-Eibrink Marry M, van den Berg Marleen H, Levine Jennifer M, van Dulmen-den Broeder Eline, di Iorgi Natascia, Albanese Assunta, Armenian Saro H, Bhatia Smita, Constine Louis S, Corrias Andreas, Deans Rebecca, Dirksen Uta, Gracia Clarisa R, Hjorth Lars, Kroon Leah, Lambalk Cornelis B, Landier Wendy, Levitt Gill, Leiper Alison, Meacham Lillian, Mussa Alesandro, Neggers Sebastian J, Oeffinger Kevin C, Revelli Alberto, van Santen Hanneke M, Skinner Roderick, Toogood Andrew, Wallace William H, Haupt Riccardo

机构信息

Wendy van Dorp and Sebastian J. Neggers, Erasmus University Medical Centre; Wendy van Dorp, Sophia Children's Hospital, Rotterdam; Renée L. Mulder and Leontien C.M. Kremer, Emma Children's Hospital and Academic Medical Centre; Marleen H. van den Berg, Eline van Dulmen-den Broeder, and Cornelis B. Lambalk, Vrije Universiteit Medical Center, Amsterdam; Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology; Hanneke M. van Santen, Wilhelmina Children's Hospital, University Medical Center, Utrecht, the Netherlands; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Jennifer M. Levine, Columbia University Medical Center; Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Natascia di Iorgi, University of Genoa; Riccardo Haupt, Istituto Giannina Gaslini, Genoa; Andreas Corrias and Alesandro Mussa, University of Turin, Turin; Alberto Revelli, S. Anna Hospital and University of Torino, Torino, Italy; Assunta Albanese, St George's University Hospitals NHS Foundation Trust; Gill Levitt and Alison Leiper, Great Ormond St Hospital for Children NHS Foundation Trust, London; Roderick Skinner, Great North Children's Hospital and Newcastle University, Newcastle upon Tyne; Andrew Toogood, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham; William H. Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Saro H. Armenian, City of Hope, Duarte, CA; Smita Bhatia and Wendy Landier, University of Alabama at Birmingham, Birmingham, AL; Rebecca Deans, University of New South Wales, Sydney, New South Wales, Australia; Uta Dirksen, Westfalian Wilhelms University Muenster, University Hospital Muenster, Germany; Clarisa R. Gracia, University of Pennsylvania, Philadelphia, PA; Lars Hjorth, Skåne University Hospital and Lund University, Lund, Sweden; Leah Kroon, Seattle Children's Hospital, Seat

出版信息

J Clin Oncol. 2016 Oct 1;34(28):3440-50. doi: 10.1200/JCO.2015.64.3288. Epub 2016 Jul 25.

Abstract

PURPOSE

Female survivors of childhood, adolescent, and young adult (CAYA) cancer who were treated with alkylating agents and/or radiation, with potential exposure of the ovaries, have an increased risk of premature ovarian insufficiency (POI). Clinical practice guidelines can facilitate these survivors' access to optimal treatment of late effects that may improve health and quality of survival; however, surveillance recommendations vary among the existing long-term follow-up guidelines, which impedes the implementation of screening.

PATIENTS AND METHODS

The present guideline was developed by using an evidence-based approach and summarizes harmonized POI surveillance recommendations for female survivors of CAYA cancer who were diagnosed at age < 25 years. The recommendations were formulated by an international multidisciplinary panel and graded according to the strength of the evidence and the potential benefit gained from early detection and intervention. The harmonized POI surveillance recommendations were developed by using a transparent process and are intended to facilitate care for survivors of CAYA cancer.

RESULTS AND CONCLUSION

The harmonized set of POI surveillance recommendations is intended to be scientifically rigorous, to positively influence health outcomes, and to facilitate the care for female survivors of CAYA cancer.

摘要

目的

接受过烷化剂和/或放疗(可能累及卵巢)治疗的儿童期、青少年期及青年期(CAYA)癌症女性幸存者,发生卵巢早衰(POI)的风险增加。临床实践指南有助于这些幸存者获得针对可能改善健康和生存质量的迟发效应的最佳治疗;然而,现有长期随访指南中的监测建议各不相同,这阻碍了筛查的实施。

患者与方法

本指南采用循证方法制定,总结了针对25岁前确诊的CAYA癌症女性幸存者的统一POI监测建议。这些建议由一个国际多学科小组制定,并根据证据强度以及早期检测和干预所带来的潜在益处进行分级。统一的POI监测建议通过透明的流程制定,旨在为CAYA癌症幸存者提供便利的医疗服务。

结果与结论

统一的POI监测建议集旨在做到科学严谨,对健康结局产生积极影响,并为CAYA癌症女性幸存者提供便利的医疗服务。

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