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儿童癌症患者的生育力保护医疗评估:欧盟“地平线2020”结对项目TREL倡议

Evaluation of oncofertility care in childhood cancer patients: the EU-Horizon 2020 twinning project TREL initiative.

作者信息

Stukaite-Ruibiene Egle, van der Perk M E Madeleine, Vaitkeviciene Goda Elizabeta, Bos Annelies M E, Bumbuliene Zana, van den Heuvel-Eibrink Marry M, Rascon Jelena

机构信息

Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.

出版信息

Front Pediatr. 2023 Jul 26;11:1212711. doi: 10.3389/fped.2023.1212711. eCollection 2023.

Abstract

BACKGROUND

The 5-year survival rate of childhood cancer exceeds 80%, however, many survivors develop late effects including infertility. The aim of this study was to evaluate the current status of oncofertility care at Vilnius University Hospital Santaros Klinikos (VULSK) within the framework of the EU-Horizon 2020 TREL project.

METHODS

All parents or patients aged 12-17.9 years treated from July 1, 2021 until July 1, 2022 were invited to complete an oncofertility-care-evaluation questionnaire. After completing the questionnaire, patients were triaged to low-risk (LR) or high-risk (HR) of gonadal damage using a risk stratification tool (triage). Data was assessed using descriptive statistics.

RESULTS

Questionnaires were completed by 48 parents and 13 children triaged as 36 (59%) LR and 25 (41%) HR patients. Most HR respondents (21/25, 84%) were not counseled by a fertility specialist. Six boys (4 HR, 2 LR) were counseled, none of the girls was counseled. Three HR boys underwent sperm cryopreservation. Only 17 (27.9%, 9 HR, 8 LR) respondents correctly estimated their risk. All counseled boys ( = 6) agreed the risk for fertility impairment had been mentioned as compared to 49.1% ( = 27) of uncounseled. All counseled respondents agreed they knew enough about fertility (vs. 42%).

CONCLUSIONS

Respondents counseled by a fertility specialist were provided more information on fertility than uncounseled. HR patients were not sufficiently counseled by a fertility specialist. Based on the current experience oncofertility care at VULSK will be improved.

摘要

背景

儿童癌症的5年生存率超过80%,然而,许多幸存者会出现包括不孕不育在内的晚期效应。本研究的目的是在欧盟地平线2020 TREL项目框架内,评估维尔纽斯大学医院圣塔罗斯临床中心(VULSK)的肿瘤生育护理现状。

方法

邀请了2021年7月1日至2022年7月1日期间接受治疗的所有年龄在12至17.9岁的父母或患者填写一份肿瘤生育护理评估问卷。完成问卷后,使用风险分层工具(分诊)将患者分为性腺损伤低风险(LR)或高风险(HR)。数据采用描述性统计进行评估。

结果

48名父母和13名儿童完成了问卷,分诊为36名(59%)LR患者和25名(41%)HR患者。大多数HR受访者(21/25,84%)没有接受生育专家的咨询。6名男孩(4名HR,2名LR)接受了咨询,没有女孩接受咨询。3名HR男孩进行了精子冷冻保存。只有17名(27.9%,9名HR,8名LR)受访者正确估计了自己的风险。所有接受咨询的男孩(n = 6)都同意提到了生育能力受损的风险,而未接受咨询的男孩中这一比例为49.1%(n = 27)。所有接受咨询的受访者都同意他们对生育了解得足够多(相比之下为42%)。

结论

接受生育专家咨询的受访者比未接受咨询的受访者获得了更多关于生育的信息。HR患者没有得到生育专家足够的咨询。基于目前的经验,VULSK的肿瘤生育护理将得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6536/10411952/7dce1579130f/fped-11-1212711-g001.jpg

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