首页|White paper: Oncofertility in pediatric patients with Wilms tumor

White paper: Oncofertility in pediatric patients with Wilms tumor

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  • NSTL
  • Wiley
Abstract The survival of childhood Wilms tumor is currently around 90%, with many survivors reaching reproductive age. Chemotherapy and radiotherapy are established risk factors for gonadal damage and are used in both COG and SIOP Wilms tumor treatment protocols. The risk of infertility in Wilms tumor patients is low but increases with intensification of treatment including the use of alkylating agents, whole abdominal radiation or radiotherapy to the pelvis. Both COG and SIOP protocols aim to limit the use of gonadotoxic treatment, but unfortunately this cannot be avoided in all patients. Infertility is considered one of the most important late effects of childhood cancer treatment by patients and their families. Thus, timely discussion of gonadal damage risk and fertility preservation options is important. Additionally, irrespective of the choice for preservation, consultation with a fertility preservation (FP) team is associated with decreased patient and family regret and better quality of life. Current guidelines recommend early discussion of the impact of therapy on potential fertility. Since most patients with Wilms tumors are prepubertal, potential FP methods for this group are still considered experimental. There are no proven methods for FP for prepubertal males (testicular biopsy for cryopreservation is experimental), and there is just a single option for prepubertal females (ovarian tissue cryopreservation), posing both technical and ethical challenges. Identification of genetic markers of susceptibility to gonadotoxic therapy may help to stratify patient risk of gonadal damage and identify patients most likely to benefit from FP methods.

fertility preservationgonadal damagepediatric cancerWilms tumor

Amy L. Walz、Andrew D. Woods、Marry M. Heuvel‐Eibrink、Conrad V. Fernandez、M. E. Madeleine Perk、Nicholas G. Cost、Annelies M. E. Bos、Robert Brannigan、Tanzina Chowdhury、Andrew M. Davidoff、Najat C. Daw、Jeffrey S. Dome、Peter Ehrlich、Norbert Graf、James Geller、John Kalapurakal、Kathleen Kieran、Marcus Malek、Mary F. McAleer、Elizabeth Mullen、Luke Pater、Angela Polanco、Rodrigo Romao、Amanda F. Saltzman

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Division of Hematology, Oncology, Neuro‐Oncology, and Stem Cell Transplant,Ann & Robert H. Lurie

Children's Cancer Therapy Development Institute

Princess Máxima Center for Pediatric Oncology

Department of Pediatric Hematology/Oncology,IWK Health Centre and Dalhousie University

Department of Surgery, Division of Urology,University of Colorado School of Medicine and the

Reproductive Medicine and Gynaecology,University Medical Center Utrecht

Department of Urology,Northwestern University

Great Ormond Street Hospital for Children NHS Foundation Trust

Department of Surgery,St. Jude Children's Research Hospital

Department of Pediatrics—Patient Care,MD Anderson Cancer Center

Division of Oncology at Children's National Hospital

C.S. Mott Children's Hospital Section of Pediatric Surgery,University of Michigan

Department for Pediatric Oncology and Hematology,Saarland University Medical Center

Division of Pediatric Oncology,Cincinnati Children's Hospital Medical Center, University of

Department of Radiation Oncology,Northwestern University

Department of Urology,University of Washington

Division of Pediatric General and Thoracic Surgery,UPMC Children's Hospital of Pittsburgh

Department of Radiation Oncology,The University of Texas MD Anderson Cancer Center

Department of Pediatric Oncology,Children's Hospital Boston/Dana‐Farber Cancer Institute

Department of Radiation Oncology,University of Cincinnati

National Cancer Research Institute Children's Group Consumer Representative

Departments of Surgery and Urology, IWK Health Centre,Dalhousie University

Department of Urology,University of Kentucky

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2022

10.1002/ijc.34006

International Journal of Cancer

International Journal of Cancer

SCI
ISSN：0020-7136
年,卷(期)：2022.151(6)
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