AI Article Synopsis
- Data on the impact of chemotherapy on fertility (gonadotoxicity) is crucial for advising young cancer patients about infertility risks and fertility preservation options, but recent studies on bone cancer have been lacking.
- A systematic review included 11 relevant studies since 2000, revealing that a significant percentage of male patients (52.2% for osteosarcoma and 89.5% for Ewing's sarcoma) showed signs of suspected infertility, while female patients had lower rates (5.1% for osteosarcoma and 13.0% for Ewing's).
- The studies revealed that Ewing’s sarcoma patients, particularly those receiving alkylating-agent chemotherapy, had a higher risk of infertility; however
Article Abstract
Data on gonadotoxicity of chemotherapies are essential to better counsel young females and males about the risk of infertility and to better indicate fertility preservation measures before cancer therapies. However, such data have not recently been reviewed for bone cancer. Therefore, a systematic literature search was conducted considering papers published since 2000. This study is part of the FertiTOX project, which aims to improve the lack of data regarding gonadotoxicity of cancer therapies to enable more accurate counseling regarding fertility preservation. Only relapse-free women and men were included. Gonadotoxic therapy-induced suspected infertility was defined as very low anti-mullerian hormone, high gonadotropin concentration, amenorrhea, oligomenorrhea, azoospermia, or oligozoospermia. The quality of the individual studies was assessed using the Newcastle-Ottawa Scale (NOS). In total, 11 out of 831 studies were included in the review. Suspected infertility was found in 10/190 (5.1%, range 0%-66%) of female patients with osteosarcoma (six studies), in 24/46 (52.2%, range 46%-100%) of male patients with osteosarcoma (three studies), in 18/138 (13.0%, range 3%-18%) of female patients with Ewing's sarcoma (three studies), and in 34/38 (89.5%) of male patients with Ewing's sarcoma (one study). A risk calculation in relation to specific chemotherapies was not possible. Risk of suspected infertility tends to be higher in Ewing's sarcoma in which all patients received chemotherapies with alkylating agents. Two of the 11 included studies received a high NOS quality score, whereas the remaining nine studies received a low quality score, mainly because of the lack of a comparator group. Published data are too limited for precise estimation of the gonadotoxicity. However, data indicate clinically relevant risk for infertility, supporting counseling patients before chemotherapy about fertility preservation measures.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322626 | PMC |
| http://dx.doi.org/10.1089/jayao.2023.0185 | DOI Listing |
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