Gosset A, Cohade C, Grosclaude P, Oumsack E, Dalenc F, Montagut M, Parinaud J, Vaysse C
Département de médecine de la reproduction, CHU de Toulouse, 330, avenue de Grande Bretagne, TSA 70034, 31059 Toulouse, France.
Registre des cancers du Tarn, institut Claudius-Regaud, institut universitaire du cancer de Toulouse-Oncopole, 31059 Toulouse, France; Inserm, UMR1027, université de Toulouse, université Paul-Sabatier, 31000 Toulouse, France.
Gynecol Obstet Fertil Senol. 2019 Oct;47(10):732-738. doi: 10.1016/j.gofs.2019.08.005. Epub 2019 Sep 4.
According to the 2004 Bioethics Act, oncofertility counselling must be systematically offered to all women of childbearing age before they are exposed to potentially gonadotoxic treatment. The main objective of this study was to evaluate the proportion of women under 40 years of age treated with chemotherapy for breast cancer in Midi-Pyrénées who have received an oncofertility consultation. A secondary objective was to assess practitioners' knowledge on the subject.
A cross-reference was made between the databases of the oncology network in Midi-Pyrénées and the two approved centres for the preservation of fertility in the region. A computerized practitioner questionnaire was sent to all surgeons and oncologists who could manage these patients.
From 2012 and 2017, 667 women aged≤40 years received (neo)adjuvant chemotherapy treatment: only 156 (23.4%) had access to an oncofertility consultation and 58 (8.7%) received preservation. This rate (23.4%) varied according to the age of the patients, ranging from 56.9% for those aged 25-29 to 13.4% for those aged 35-39 and the managing institution. Of the 85 practitioners surveyed, 45 (55%) responded to the questionnaire, and of these 20 (44%) knew that ovarian stimulation treatment could be used even in hormone-dependent breast cancer situations and 13 (29%) of practitioners believed that the time required to preserve fertility was more than 1 month.
Our study revealed a significant disparity in access to oncofertility consultation. It is essential to set up information and awareness-raising actions on the subject.
根据2004年《生物伦理学法案》,必须在所有育龄妇女接受可能具有性腺毒性的治疗之前,系统地为其提供生育力保护咨询。本研究的主要目的是评估在南比利牛斯地区接受乳腺癌化疗的40岁以下女性中,接受生育力保护咨询的比例。次要目的是评估从业者对该主题的了解情况。
对南比利牛斯地区肿瘤学网络数据库与该地区两个获批的生育力保存中心的数据库进行交叉比对。向所有能够管理这些患者的外科医生和肿瘤学家发送了一份计算机化的从业者调查问卷。
2012年至2017年期间,667名年龄≤40岁的女性接受了(新)辅助化疗:只有156名(23.4%)能够获得生育力保护咨询,58名(8.7%)接受了生育力保存。这一比例(23.4%)因患者年龄而异,25 - 29岁的患者为56.9%,35 - 39岁的患者为13.4%,且因管理机构不同而有所差异。在接受调查的85名从业者中,45名(55%)回复了问卷,其中20名(44%)知道即使在激素依赖性乳腺癌的情况下也可以使用卵巢刺激治疗,13名(29%)从业者认为保存生育力所需的时间超过1个月。
我们的研究揭示了在获得生育力保护咨询方面存在显著差异。开展关于该主题的信息和宣传活动至关重要。