PL EN


Preferences help
enabled [disable] Abstract
Number of results
2009 | 7 | 2 | 97-106
Article title

Aktualne poglądy dotyczące możliwości zachowania płodności u pacjentek leczonych terapią przeciwnowotworową

Content
Title variants
EN
Current opinions on possible preservation of fertility in patients undergoing antineoplastic therapy
Languages of publication
EN PL
Abstracts
EN
Implementation of increasingly aggressive protocols in oncology results in increasing permanent cure rates. This is particularly noticeable in the youngest age group, including women of reproductive age. In this population of patients, permanent cure rates may reach 75% according to some authors. Unfortunately, implemented treatment frequently results in a compromised function of gonads and associated therewith secondary infertility, thus significantly influencing the patients’ quality of life. Aggressive and multidrug systemic therapy, used in most frequent paediatric malignancies, e.g. in Hodgkin disease or haematological neoplasms, is associated with high risk of ovarian damage. Particularly gonadotoxic effects have been documented after radiotherapy and alkylating agents-based chemotherapy. At present, there are several methods aiming at preservation of reproductive capacity of patients undergoing such treatment. Currently used transposition of ovaries out of irradiated area and freezing of embryos, in spite of considerable effectiveness, are burdened by several limitations and do not solve the problem of infertility in a satisfactory way, particularly in the youngest oncologic patients. Recently, research is focused on attempts of using GnRH agonists and antagonists, as well as on freezing immature oocytes. Among novel techniques, considerable hopes are associated with freezing and transplantation of ovarian tissue. These procedures do not delay implementation of antineoplastic treatment and do not compromise its effectiveness, but as novel still raise much controversy and debate.
PL
Stosowanie coraz bardziej agresywnych schematów w terapii nowotworów skutkuje coraz większym odsetkiem trwałych wyleczeń. Szczególnie widoczne jest to w najmłodszej grupie wiekowej, obejmującej kobiety w wieku rozrodczym. W tej grupie chorych odsetek trwałych wyleczeń według niektórych autorów osiąga nawet 75%. Zastosowane leczenie często prowadzi do upośledzenia funkcji gonad i związanej z tym następowej niepłod­ności, a tym samym znacząco wpływa na jakość życia. Ciężka wielolekowa terapia systemowa stosowana w często występujących nowotworach u dzieci, takich jak choroba Hodgkina, czy nowotworach hematologicz­nych zaliczana jest do terapii dużego ryzyka uszkodzenia jajników. Szczególną gonadotoksyczność wykazano w przypadku radioterapii i chemioterapii związkami alkilującymi. Obecnie istnieje kilka metod skoncentrowa­nych na utrzymaniu zdolności do rozrodu u pacjentek poddanych takiemu leczeniu. Dotychczas stosowane transpozycje jajników poza obszar napromieniowania i zamrażanie embrionów, pomimo dużej skuteczności, są metodami z dużą ilością ograniczeń i wydają się niewystarczającym rozwiązaniem problemu bezpłodności, szczególnie u najmłodszych pacjentek onkologicznych. W ostatnich latach wiele uwagi poświęca się próbom sto­sowania terapii zarówno agonistami, jak i antagonistami GnRH oraz zamrażaniu niedojrzałych oocytów. Wśród nowych metod znalazła się również budząca duże nadzieje metoda zamrażania i transplantacji tkanki jajniko­wej. Metody te nie opóźniają leczenia przeciwnowotworowego oraz nie wpływają na jego skuteczność, niemniej jednak jako nowości wciąż budzą kontrowersje.
Discipline
Year
Volume
7
Issue
2
Pages
97-106
Physical description
References
  • 1. Bines J., Oleske D.M., Cobleigh M.A.: Ovarian function in premenopausal women treated with adjuvant chemotherapy for breast cancer. J. Clin. Oncol. 1996; 14: 1718-1729.
  • 2. Blumenfeld Z., Avivi I., Ritter M., Rowe J.M.: Preservation of fertility and ovarian function and minimizing chemotherapy induced gonadotoxicity in young women. J. Soc. Gynecol. Investig. 1999; 6: 229-239.
  • 3. Ataya K., Moghissi K.: Chemotherapy-induced premature ovarian failure: mechanisms and prevention. Steroids 1989; 54: 607-626.
  • 4. Shalet S.M., Beardwell C.G., Morris EH. i wsp.: Ovarian failure following abdominal irradiation in childhood. Br. J. Cancer 1976; 33: 655-658.
  • 5. Chemaitilly W, Mertens A.C., Mitby P i wsp.: Acute ovarian failure in the childhood cancer survivor study. J. Clin. Endocrinol. Metab. 2006; 91: 1723-1728.
  • 6. Wallace W H., Anderson R.A., Irvine D.S.: Fertility preservation for young patients with cancer: who is at risk and what can be offered? Lancet Oncol. 2005; 6: 209-218.
  • 7. Rebar R.W: Premature ovarian ’’failure” in the adolescent. Ann. N. Y. Acad. Sci. 2008; 1135: 138-145.
  • 8. Lobo R.A.: Potential options for preservation of fertility in women. N. Engl. J. Med. 2005; 353: 64-73.
  • 9. Averette H.E., Boike G.M., Jarrell M.A.: Effects of cancer chemotherapy on gonadal function and reproductive capacity. CA Cancer J. Clin. 1990; 40: 199-209.
  • 10. Familiari G., Caggiati A., Nottola S.A. i wsp.: Ultrastructure of human ovarian primordial follicles after combination chemother­apy for Hodkin’s disease. Hum. Reprod. 1993; 8: 2080-2087.
  • 11. Goodwin PJ., Ennis M., Pritchard K.I.: Risk of menopause during the first year after breast cancer diagnosis. J. Clin. Oncol. 1999; 17: 2365-2370.
  • 12. Sonmezer M., Oktay K.: Fertility preservation in female patients. Hum. Reprod. Update 2004; 10: 251-266.
  • 13. Byrne J., Fears TR., Gail M.H. i wsp.: Early menopause in long­term survivors of cancer during adolescence. Am. J. Obstet. Gynecol. 1992; 166: 788-793.
  • 14. Meirow D., Nugent D.: The effects of radiotherapy and chemotherapy on female reproduction. Hum. Reprod. Update 2001; 7: 535-543.
  • 15. Lee S.J., Schover L.R., Partridge A.H. i wsp.: American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J. Clin. Oncol. 2006; 24: 2917-2931.
  • 16. Wallace Wh., Thomson A.B., Kelsey TW: The radiosensitivity of the human oocyte. Hum. Reprod. 2003; 18: 117-121.
  • 17. Wallace W.H., Thomson A.B., Saran F. i wsp.: Predicting age of ovarian failure after radiation to a field that includes the ovaries. Int. J. Radiat. Oncol. Biol. Phys. 2005; 62: 738-744.
  • 18. Wallace W.H.B., Shalet S.M., Crowne E.C. i wsp.: Ovarian failure following abdominal irradiation in childhood: natural history and prognosis. Clin. Oncol. (R. Coll. Radiol.) 1989; 1: 75-79.
  • 19. Sanders J.E., Hawley J., Levy W i wsp.: Pregnancies following high-dose cyclophosphamide with or without high-dose busulfan or total body irradiation and bone marrow transplantation. Blood 1996; 87: 3045-3052.
  • 20. Lee S.J., Schover L.R., Partridge A.H.: American Society of Clinical Oncology Recommendations on Fertility Preservation in Cancer Patients. J. Clin. Oncol. 2006; 24: 2917-2931.
  • 21. Anderson B., LaPolla J., Turner D. i wsp.: Ovarian transposition in cervical cancer. Gynecol. Oncol. 1993; 49: 206-214.
  • 22. Blumenfeld Z., Eckamn A.: Preservation of fertility and ovarian function and minimization of chemotherapy-induced gonadotoxicity in young woman by GnRH-a. J. Natl. Cancer Inst. Monogr. 2005; 34: 40-43. Pereyra Pacheco B., Mendez Ribas J.M., Milone G. i wsp.: Use of GnRH analogs for functional protection of the ovary and preservation of fertility during cancer treatment in adolescents: a preliminary report. Gynecol. Oncol. 2001; 81: 391-397.
  • 24. Blumfeld Z.: How to preserve fertility in young woman exposed to chemotherapy? The role of GnRH agonist cotreatment in addition to cryopreservation of embrya, oocytes, or ovaries. Oncologist 2007; 12: 1044-1054.
  • 25. Waxma J.H., Ahmed R., Smith D. i wsp.: Failure to preserve fertility in patients with Hodkin’s disease. Cancer Chemother. Pharmacol. 1987; 19: 159-162.
  • 26. Oktay K., Cil AP, Bang H.: Efficiency of oocyte cryopreser­vation: a meta-analysis. Fertil. Steril. 2006; 86: 70-80.
  • 27. Dolmans M.M., Demylle D., Martinez-Madrid B., Donnez J.: Efficacy of in vitro fertilization after chemotheraphy. Fertil. Steril. 2005; 83: 897-901.
  • 28. Porcu E., Fabri R., Damiano G. i wsp.: Clinical experience and applications of oocyte cryopreservation. Mol. Cell Endocrinol. 2000; 169: 33-37.
  • 29. Borini A., Bonu MA, Coticchio G. i wsp.: Pregnancies and births after oocyte cryopreservation. Fertil. Steril. 2004; 82: 601-605.
  • 30. Cha K.Y., Koo J.J., Ko J.J. i wsp.: Pregnancy after in vitro fertil-ization of human follicular oocytes collected from nonstimulated cycles, their culture in vitro and their trans­fer in a donor oocyte program. Fertil. Steril. 1991; 55: 109-113.
  • 31. Trounson A.O., Wood C., Kausche A.: In vitro maturation and the fertilization and development competence of oocytes recovered for untreated polycystic ovarian patients. Fertil. Steril. 1994; 62: 353-362.
  • 32. Russel J.B., Knezevich K.M., Fabian K.F, Dickson J.A.: Unstim­ulated immature oocytes retrieval: early versus midfollicular endometrial priming. Fertil. Steril. 1997; 67: 616-620.
  • 33. Oktay K., Karlikaya G.: Ovarian function after transplantation of frozen, banked autologous ovarian tissue. N. Engl. J. Med. 2000; 342: 1919.
  • 34. Demeestere I., Simon P., Emiliani S.: Fertility preservation: successful transplantation of cryopreserved ovarian tissue in a young patient previously treated for Hodgkin's disease. Oncologist 2007; 12: 1437-1442.
  • 35. Donnez J., Dolmans M.M., Demylle D.: Livebirth after ortho­topic transplantation of cryopreserved ovarian tissue. Lancet 2004; 364: 1405-1410.
  • 36. Meirow D., Levron J., Eldar-Geva T i wsp.: Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N. Engl. J. Med. 2005; 353: 318-321.
  • 37. Demeestere I., Simon P., Buxant F. i wsp.: Ovarian function and spontaneous pregnancy after combined heterotopic and orthotopic cryopreserved ovarian tissue transplantation in a patient previously treated with bone marrow transplanta­tion: case report. Hum. Reprod. 2006; 21: 2010-2014.
  • 38. Seshadri T., Gook D., Lade S. i wsp.: Lack of evidence of disease contamination in ovarian tissue harvested for cryo - preservation from patients with Hodgkin lymphoma and analysis of factors predictive of oocyte yield. Br. J. Cancer 2006; 94: 1007-1010.
  • 39. Kim S.S., Radford J., Harris M.: Ovarian tissue harvested from lymphoma patients to preserve fertility may be safe for autotransplantation. Hum. Reprod. 2001; 16: 2056-2060.
  • 40. Curtin J.P., Barakat R.R., Hoskins W.J.: Ovarian disease in women with breast cancer. Obstet. Gynecol. 1994; 84: 449-452.
  • 41. Li C.I., Anderson B.O., Daling J.R., Moe R.E.: Trends in incidence rates of invasive lobular and ductal breast carcinoma. JAMA 2003; 289: 1421-1424.
  • 42. Perrotin F., Marret H., Bouquin R.: Incidence diagnosis and prognosis of ovarian metastasis in breast cancer. Gynecol. Obstet. Fertil. 2001; 29: 308-315.
Document Type
article
Publication order reference
YADDA identifier
bwmeta1.element.psjd-00a1d315-8b6b-4f42-b310-67eb8ef8bf4b
Identifiers
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.