Department of Paediatric and Adolescent Haematology/Oncology and Children's Haemopoietic Stem Cell Transplant Unit, Great North Children's Hospital and Northern Institute of Cancer Research, Newcastle University, Newcastle upon Tyne, UK.
Department of Pediatric Oncology, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands.
Lancet Oncol. 2017 Feb;18(2):e75-e90. doi: 10.1016/S1470-2045(17)30026-8.
Treatment with chemotherapy, radiotherapy, or surgery that involves reproductive organs can cause impaired spermatogenesis, testosterone deficiency, and physical sexual dysfunction in male pubertal, adolescent, and young adult cancer survivors. Guidelines for surveillance and management of potential adverse effects could improve cancer survivors' health and quality of life. Surveillance recommendations vary considerably, causing uncertainty about optimum screening practices. This clinical practice guideline recommended by the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium, developed using evidence-based methodology, critically synthesises surveillance recommendations for gonadotoxicity in male childhood, adolescent, and young adult (CAYA) cancer survivors. The recommendations were developed by an international multidisciplinary panel including 25 experts in relevant medical specialties, using a consistent and transparent process. Recommendations were graded according to the strength of underlying evidence and potential benefit gained by early detection and appropriate management. The aim of the recommendations is to enhance evidence-based care for male CAYA cancer survivors. The guidelines reveal the paucity of high-quality evidence, highlighting the need for further targeted research.
治疗涉及生殖器官的化疗、放疗或手术会导致青春期、青少年和年轻成年癌症幸存者的精子发生受损、睾酮缺乏和身体性功能障碍。监测和管理潜在不良反应的指南可以改善癌症幸存者的健康和生活质量。监测建议差异很大,导致对最佳筛查实践的不确定性。本临床实践指南由国际儿童癌症晚期效应指南协调小组与 PanCareSurFup 联盟合作推荐,使用循证方法制定,对男性儿童、青少年和年轻成年(CAYA)癌症幸存者性腺毒性的监测建议进行了批判性综合。这些建议由一个包括 25 名相关医学专业专家的国际多学科小组制定,使用一致和透明的流程。建议根据潜在证据的强度和早期检测和适当管理带来的潜在益处进行分级。这些建议的目的是加强对男性 CAYA 癌症幸存者的循证护理。该指南揭示了高质量证据的缺乏,强调了进一步有针对性研究的必要性。