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在资源优化配置情况下为常见癌症开展生育力保存项目(Repro-Can-OPEN研究第二部分):委员会意见

Installing oncofertility programs for common cancers in optimum resource settings (Repro-Can-OPEN Study Part II): a committee opinion.

出版信息

J Assist Reprod Genet. 2021 Jan;38(1):163-176. doi: 10.1007/s10815-020-02012-0. Epub 2021 Jan 16.

Abstract

PURPOSE

The main objective of Repro-Can-OPEN Study Part 2 is to learn more about oncofertility practices in optimum resource settings to provide a roadmap to establish oncofertility best practice models.

METHODS

As an extrapolation for oncofertility best practice models in optimum resource settings, we surveyed 25 leading and well-resourced oncofertility centers and institutions from the USA, Europe, Australia, and Japan. The survey included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer.

RESULTS

All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed three major characteristics of oncofertility practice in optimum resource settings: (1) strong utilization of sperm freezing, egg freezing, embryo freezing, ovarian tissue freezing, gonadal shielding, and fractionation of chemo- and radiotherapy; (2) promising utilization of GnRH analogs, oophoropexy, testicular tissue freezing, and oocyte in vitro maturation (IVM); and (3) rare utilization of neoadjuvant cytoprotective pharmacotherapy, artificial ovary, in vitro spermatogenesis, and stem cell reproductive technology as they are still in preclinical or early clinical research settings. Proper technical and ethical concerns should be considered when offering advanced and experimental oncofertility options to patients.

CONCLUSIONS

Our Repro-Can-OPEN Study Part 2 proposed installing specific oncofertility programs for common cancers in optimum resource settings as an extrapolation for best practice models. This will provide efficient oncofertility edification and modeling to oncofertility teams and related healthcare providers around the globe and help them offer the best care possible to their patients.

摘要

目的

生殖-加拿大-开放研究第二部分的主要目标是进一步了解资源充足环境下的肿瘤生育实践,以提供建立肿瘤生育最佳实践模式的路线图。

方法

作为对资源充足环境下肿瘤生育最佳实践模式的推断,我们调查了来自美国、欧洲、澳大利亚和日本的25家领先且资源丰富的肿瘤生育中心和机构。该调查包括关于儿童癌症、乳腺癌和血癌患者生育力保存选项的可用性和利用程度的问题。

结果

所有接受调查的中心都回答了所有问题。回答及其计算得出的肿瘤生育分数显示了资源充足环境下肿瘤生育实践的三个主要特征:(1)精子冷冻、卵子冷冻、胚胎冷冻、卵巢组织冷冻、性腺屏蔽以及化疗和放疗分割的广泛应用;(2)促性腺激素释放激素类似物、卵巢固定术、睾丸组织冷冻和卵母细胞体外成熟(IVM)的有前景的应用;(3)新辅助细胞保护药物治疗、人工卵巢、体外精子发生和干细胞生殖技术应用较少,因为它们仍处于临床前或早期临床研究阶段。在为患者提供先进和实验性肿瘤生育选项时,应考虑适当的技术和伦理问题。

结论

我们的生殖-加拿大-开放研究第二部分建议在资源充足的环境中为常见癌症设立特定的肿瘤生育项目,作为最佳实践模式的推断。这将为全球肿瘤生育团队和相关医疗保健提供者提供有效的肿瘤生育教育和模式,并帮助他们为患者提供尽可能最佳的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c53a/7822998/dddde4098e2f/10815_2020_2012_Fig1_HTML.jpg

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