Annelies Overbeek1, Marleen H van den Berg2, Flora E van Leeuwen3, Gertjan J L Kaspers4, Cornelis B Lambalk5, Eline van Dulmen-den Broeder2. 1. Department of Pediatrics, Division of Pediatric Oncology/Haematology, VU University Medical Center, Amsterdam, Netherlands; Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands. Electronic address: a.overbeek@vumc.nl. 2. Department of Pediatrics, Division of Pediatric Oncology/Haematology, VU University Medical Center, Amsterdam, Netherlands. 3. Netherlands Cancer Institute, Amsterdam, Netherlands. 4. Department of Pediatrics, Division of Pediatric Oncology/Haematology, VU University Medical Center, Amsterdam, Netherlands; Princess Máxima Center of Pediatric Oncology, Utrecht, Netherlands. 5. Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands.
Abstract
BACKGROUND: Anti-cancer treatment may reduce the fertile life span and induce premature menopause. This review aims to provide an overview of the available literature on effects of chemotherapy only on the incidence of ovarian dysfunction and to evaluate the relationship between dose of chemotherapy, age at time of treatment, and time since treatment in female survivors of childhood and young adult cancer. METHODS: A comprehensive search of electronic databases was performed (search date December 2015). RESULTS: 45 studies were included, describing, in total, 5607 female survivors. Median age at menopause was earlier in cancer survivors than in the general population. The prevalence of amenorrhoea varied from 0% to 83%. Those exposed to MVPP protocols were at highest risk for amenorrhoea (39-79%), as were breast cancer survivors receiving cyclophosphamide-containing regimens, in whom the prevalence of amenorrhoea was 40-80%. The most important risk factors for ovarian dysfunction were: (1) alkylating agents, specifically procarbazine and busulfan, (2) older age at treatment. CONCLUSION: Breast cancer survivors, those treated with procarbazine or other alkylating agents and those with a higher age at diagnosis are at highest risk of diminished ovarian function. However, all studies included in this review showed methodological limitations. It is imperative that nation-wide registries guarantee long term follow-up during the adult life of cancer survivors.
BACKGROUND: Anti-cancer treatment may reduce the fertile life span and induce premature menopause. This review aims to provide an overview of the available literature on effects of chemotherapy only on the incidence of ovarian dysfunction and to evaluate the relationship between dose of chemotherapy, age at time of treatment, and time since treatment in female survivors of childhood and young adult cancer. METHODS: A comprehensive search of electronic databases was performed (search date December 2015). RESULTS: 45 studies were included, describing, in total, 5607 female survivors. Median age at menopause was earlier in cancer survivors than in the general population. The prevalence of amenorrhoea varied from 0% to 83%. Those exposed to MVPP protocols were at highest risk for amenorrhoea (39-79%), as were breast cancer survivors receiving cyclophosphamide-containing regimens, in whom the prevalence of amenorrhoea was 40-80%. The most important risk factors for ovarian dysfunction were: (1) alkylating agents, specifically procarbazine and busulfan, (2) older age at treatment. CONCLUSION:Breast cancer survivors, those treated with procarbazine or other alkylating agents and those with a higher age at diagnosis are at highest risk of diminished ovarian function. However, all studies included in this review showed methodological limitations. It is imperative that nation-wide registries guarantee long term follow-up during the adult life of cancer survivors.
Authors: Sarah Colonna; Karen Curtin; Eric Johnson; Wendy Kohlmann; Jennifer Wright; Anne Kirchhoff; Sean Tavtigian; Joshua Schiffman Journal: Int J Cancer Clin Res Date: 2019-02-25
Authors: Wendy van Dorp; Riccardo Haupt; Richard A Anderson; Renee L Mulder; Marry M van den Heuvel-Eibrink; Eline van Dulmen-den Broeder; H Irene Su; Jeanette Falck Winther; Melissa M Hudson; Jennifer M Levine; W Hamish Wallace Journal: J Clin Oncol Date: 2018-06-06 Impact factor: 44.544
Authors: Alexa C O Medica; Brian W Whitcomb; Ksenya Shliakhsitsava; Andrew C Dietz; Kelsey Pinson; Christina Lam; Sally A D Romero; Patrick Sluss; Mary D Sammel; H Irene Su Journal: J Clin Endocrinol Metab Date: 2021-01-23 Impact factor: 5.958