Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer.
Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer.
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DOI：
10.1002/cncr.26459
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发表时间：
2012-03-15
期刊：
影响因子：
6.2
通讯作者：
Rosen MP
中科院分区：
文献类型：
--
作者：
Letourneau JM;Ebbel EE;Katz PP;Katz A;Ai WZ;Chien AJ;Melisko ME;Cedars MI;Rosen MP
在针对育龄癌症女性的大规模研究中，尚未描述接受癌前治疗不孕不育咨询和追求保留生育能力对治疗后生活质量 (QOL) 的影响。 1041 名年龄在 18 岁至 40 岁之间的女性接受了一项回顾性调查，报告她们在癌症治疗前是否接受过不孕不育咨询，以及是否采取了保留生育能力的行动。包括五种癌症类型：白血病、霍奇金病、非霍奇金淋巴瘤、乳腺癌和胃肠道癌症。使用经过验证的生活质量量表：决策遗憾评分 (DRS)、生活满意度量表 (SWLS) 和世界卫生组织生活质量 BREF (WHOQOL-BREF)。 560 名治疗可能影响生育能力的女性 (61%) 接受了肿瘤学团队的咨询，45 名 (5%) 名女性接受了生育专家的咨询，36 名 (4%) 名女性采取了保留生育能力的行动。由生育专家和肿瘤科医生提供的治疗前不孕不育咨询的后悔率低于仅由肿瘤科医生提供的咨询（8.4 vs. 11.0，P<0.0001）。与仅由肿瘤科医生进行咨询相比，增加生育力保留（6.6 vs. 11.0，P<0.0001）也与更低的后悔评分相关。在增加生育专家咨询（23.0 vs. 19.8，P=0.09）或保留生育力（24.0 vs. 19.0，P=0.05）的情况下，SWLS 中也出现了类似的进一步改善。接受有关生殖损失的专门咨询和追求生育力保留可以减少幸存者的遗憾并提高生活质量，但很少有患者能够获得这种潜在的好处。育龄妇女应接受专家咨询，并有机会就保留生育能力做出积极的决定。
The post-treatment quality of life (QOL) impacts of receiving pre-cancer-treatment infertility counseling and of pursuing fertility preservation have not been described in large-scale studies of reproductive age women with cancer. 1041 women diagnosed between the ages of 18 and 40 responded to a retrospective survey and reported whether they received infertility counseling before cancer treatment and whether they took action to preserve fertility. Five cancer types were included: leukemia, Hodgkin’s disease, non-Hodgkin lymphoma, breast cancer, and gastrointestinal cancer. Validated QOL scales were used: Decision Regret Score (DRS), Satisfaction with Life Scale (SWLS), and World Health Organization QOL BREF (WHOQOL-BREF). 560 women (61%) whose treatment could affect fertility were counseled by the oncology team, 45 (5%) were counseled by fertility specialists, 36 (4%) took action to preserve fertility. Pre-treatment infertility counseling by a fertility specialist and an oncologist resulted in lower regret than counseling by an oncologist alone (8.4 vs. 11.0, P<0.0001). The addition of fertility preservation (6.6 vs. 11.0, P<0.0001) was also associated with even lower regret scores than counseling by an oncologist alone.. Further improvements were similarly seen in SWLS with the addition of fertility specialist counseling (23.0 vs. 19.8, P=0.09) or preserving fertility (24.0 vs. 19.0, P=0.05). Receiving specialized counseling about reproductive loss and pursuing fertility preservation is associated with less regret and greater QOL for survivors, yet few patients are exposed to this potential benefit. Reproductive aged women should have expert counseling and be given the opportunity to make active decisions about preserving fertility.
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影响因子：
3
作者：
Madrigrano, Andrea;Westphal, Lynn;Wapnir, Irene
通讯作者：
Wapnir, Irene
影响因子：
3.2
作者：
Schover, Leslie R.
通讯作者：
Schover, Leslie R.
DOI：
10.1007/s11764-007-0004-3
发表时间：
2007-03-01
期刊：
Journal of cancer survivorship : research and practice
影响因子：
--
作者：
Arora, Neeraj K;Hamilton, Ann S;Stevens, Jennifer
通讯作者：
Stevens, Jennifer
影响因子：
6.7
作者：
Klock, Susan C.;Zhang, John X.;Kazer, Ralph R.
通讯作者：
Kazer, Ralph R.
DOI：
10.3109/0167482x.2010.503910
发表时间：
2010-09-01
影响因子：
3.1
作者：
Tschudin, Sibil;Bunting, Laura;Boivin, Jacky
通讯作者：
Boivin, Jacky