Sandrine Thouvenin-Doulet1, Claire Berger1,2,3, Léonie Casagranda1,2,3,4, Odile Oberlin5, Perrine Marec-Berard6, Hélène Pacquement7, Catherine Guibout5,8,9, Claire Freycon10, Tan Dat N'Guyen11, Pierre-Yves Bondiau12, Anne Laprie13, Delphine Berchery13, Chiraz El-Fayech5,8,9, Béatrice Trombert-Paviot2,3,4, Florent de Vathaire5,8,9. 1. 1 Paediatric Haematology and Oncology Unit, University Hospital , Saint-Etienne, France . 2. 2 Childhood Cancer Registry of the Rhône-Alpes Region, University of Saint Etienne , Saint-Etienne, France . 3. 3 Clinical and Exercise Physiology Laboratory, (EA 4607 SNA EPIS), University Hospital , Saint-Etienne, France . 4. 4 Department of Public Health and Medical Informatics, University of Saint Etienne , Saint-Etienne, France . 5. 5 Department of Paediatric Oncology, Institut Gustave Roussy , Villejuif, France . 6. 6 Department of Paediatric Oncology, Institute of Paediatric Haematology and Oncology , Lyon, France . 7. 7 Department of Paediatric Oncology, Institut Curie , Paris, France . 8. 8 Inserm, U1018, Radiation Epidemiology Team, CESP Centre for Research in Epidemiology and Population Health , Villejuif, France . 9. 9 Faculté de Médecine, Université Paris XI , Villejuif, France . 10. 10 Paediatric Haematology and Oncology Unit, University Hospital of Grenoble , Grenoble, France . 11. 11 Department of Paediatric Oncology, Institut Jean Godinot , Reims, France . 12. 12 Department of Paediatric Oncology, Centre Antoine Lacassagne , Nice, France . 13. 13 Department of Paediatric Oncology, Centre Claudius Régaud , Toulouse, France .
Abstract
PURPOSE: To describe fecundity in female survivors of childhood cancer and consider the correlation with quality of life (QOL). MATERIALS AND METHODS: Of 1744 women treated for childhood cancer before the age of 15 years at one of eight French cancer treatment centers between 1948 and 1992, 1187 who were alive in 2005 were sent a self-administered questionnaire, including questions about health status, QOL (MOS SF-36), and fecundity. A standardized fecundity ratio (SFR) was calculated (SFR: observed/expected number of children) for each individual based on a national reference. RESULTS: Of the 972 individuals (82%) who responded, 53% had at least 1 child. The overall SFR, 0.65, was dependent upon the initial diagnosis, more decreased in Central Nervous System tumors (0.24; p < 10-3) than in Germ cell (0.46; p = 0.03) or Sympathetic Nervous System tumors (0.79; p = 0.02). The average QOL motor score was 72.5 ± 19.5, and the average mental score was 61.4 ± 16.7. After adjusting for age, pathology, and self-reported sequelae in the questionnaires, it was determined that SF-36 mental (p = 0.002) and motor (p < 0.0002) scores correlated positively with fecundity, and SF-36 scores correlated negatively with locomotor late effects (p < 0.0001), growth insufficiency (p = 0.002), and psychological disorders (p < 0.001). Gonadal insufficiency was correlated with neither motor nor mental scores. CONCLUSION: Women treated for childhood cancer demonstrated impaired fecundity that correlated with poor QOL, as registered by the SF-36. Patients should be warned of the risk of impaired fecundity early during the follow-up. If possible, preservation of fertility should be prioritized at initiation of therapy.
PURPOSE: To describe fecundity in female survivors of childhood cancer and consider the correlation with quality of life (QOL). MATERIALS AND METHODS: Of 1744 women treated for childhood cancer before the age of 15 years at one of eight French cancer treatment centers between 1948 and 1992, 1187 who were alive in 2005 were sent a self-administered questionnaire, including questions about health status, QOL (MOS SF-36), and fecundity. A standardized fecundity ratio (SFR) was calculated (SFR: observed/expected number of children) for each individual based on a national reference. RESULTS: Of the 972 individuals (82%) who responded, 53% had at least 1 child. The overall SFR, 0.65, was dependent upon the initial diagnosis, more decreased in Central Nervous System tumors (0.24; p < 10-3) than in Germ cell (0.46; p = 0.03) or Sympathetic Nervous System tumors (0.79; p = 0.02). The average QOL motor score was 72.5 ± 19.5, and the average mental score was 61.4 ± 16.7. After adjusting for age, pathology, and self-reported sequelae in the questionnaires, it was determined that SF-36 mental (p = 0.002) and motor (p < 0.0002) scores correlated positively with fecundity, and SF-36 scores correlated negatively with locomotor late effects (p < 0.0001), growth insufficiency (p = 0.002), and psychological disorders (p < 0.001). Gonadal insufficiency was correlated with neither motor nor mental scores. CONCLUSION:Women treated for childhood cancer demonstrated impaired fecundity that correlated with poor QOL, as registered by the SF-36. Patients should be warned of the risk of impaired fecundity early during the follow-up. If possible, preservation of fertility should be prioritized at initiation of therapy.
Entities:
Keywords:
fecundity; female survivors; long-term follow-up; quality of life
Authors: Anne-Lotte L F van der Kooi; Eva Clemens; Linda Broer; Oliver Zolk; Julianne Byrne; Helen Campbell; Marleen van den Berg; Claire Berger; Gabriele Calaminus; Uta Dirksen; Jeanette Falck Winther; Sophie D Fosså; Desiree Grabow; Riccardo Haupt; Melanie Kaiser; Tomas Kepak; Leontien Kremer; Jarmila Kruseova; Dalit Modan-Moses; Andreas Ranft; Claudia Spix; Peter Kaatsch; Joop S E Laven; Eline van Dulmen-den Broeder; André G Uitterlinden; Marry M van den Heuvel-Eibrink Journal: BMC Cancer Date: 2018-09-26 Impact factor: 4.430