TY - JOUR
T1 - Chemotherapy-related late adverse effects on ovarian function in female survivors of childhood and young adult cancer
T2 - A systematic review
AU - Overbeek, Annelies
AU - van den Berg, Marleen H
AU - van Leeuwen, Flora E
AU - Kaspers, Gertjan J L
AU - Lambalk, Cornelis B
AU - van Dulmen-den Broeder, Eline
PY - 2016/11/24
Y1 - 2016/11/24
N2 - 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.
AB - 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.
U2 - https://doi.org/10.1016/j.ctrv.2016.11.006
DO - https://doi.org/10.1016/j.ctrv.2016.11.006
M3 - Article
C2 - 28056411
SN - 0305-7372
VL - 53
SP - 10
EP - 24
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
ER -