Measures of Fertility in Young Cancer Patients

年轻癌症患者的生育能力测量

• 批准号: 7467580
• 负责人: CLARISA R. GRACIA
• 金额: $ 13.73万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-28 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7467580
• 关键词: Adolescent; Adult; Aftercare; Aging; Alkylating Agents; Area; Assisted Reproductive Technology; Biological Preservation; Cancer Patient; Cancer Survivor; Child; Childhood; Clinical; Cohort Studies; Counseling; Country; Cryopreservation; Cyclophosphamide; Data; Diagnostic; Discipline; Dose; Early Diagnosis; Embryo; Emerging Technologies; End Point; Endocrine; Endocrinology; Evaluation; Exposure to; Extramural Activities; Failure; Female; Fertility; Fertilization in Vitro; Functional disorder; Funding; Future; General Population; Goals; Health; Hormonal; Hormonal Change; Hormones; Hypothalamic structure; In Vitro; Individual; Infertility; Institution; Investigation; K-Series Research Career Programs; Knowledge; Lead; Life; Longitudinal Studies; Malignant Childhood Neoplasm; Malignant Neoplasms; Measures; Menopause; Menstrual fluid; Menstruation; Methods; Newly Diagnosed; Oocytes; Ovarian; Ovarian Function Tests; Ovarian Tissue; Ovary; Oxidative Stress; Patients; Pediatric Oncology; Phase; Physical Examination; Pituitary Gland; Population; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Premature Menopause; Premature Ovarian Failure; Protocols documentation; Radiation; Recording of previous events; Recovery; Reproductive Endocrinology; Research Personnel; Risk; Secondary to; Serum; Surrogate Markers; Survival Rate; Techniques; Testing; Therapeutic; Time; Training; Ultrasonography; Woman; age related; aged; cancer therapy; chemotherapeutic agent; chemotherapy; childhood cancer survivor; design; experience; gonad function; healthy aging; improved; interdisciplinary approach; novel; oncology; prospective; reproductive; response; time interval; young adult

Project Summary There are currently over 250,000 survivors of childhood cancer in the U.S. Recent diagnostic therapeutic advances in pediatric oncology have led to greater survival rates in children and young adults with malignancies. However, while cancer therapies improve long-term survival, such treatments can lead to impaired fertility potential and eventual premature ovarian failure. The gonadotoxic effects of chemotherapeutic agents are well documented, particularly for alkylating agents such as cyclophosphamide and appear to be dose dependent. However, while reduced reproductive potential has been recognized for many years, little information is known about the endocrinology of hypothalamic-pituitary-gonadal function in adolescents and young adults with cancer prior to, during, and after treatment. In the infertility setting, several clinical tests, including serum hormone measures and ultrasound measures of the ovaries, have been developed and are routinely used as surrogate markers to evaluate a woman's fertility potential and for counseling regarding treatment options. In addition, there is emerging data that markers of oxidative stress may reflect ovarian aging. However, it has not been established that such ovarian function testing can detect diminished fertility potential in young female cancer patients during and after cancer treatment. Early detection of decreased fertility potential in cancer survivors would help to identify individuals who would benefit from aggressive treatment with existing assisted reproductive technologies and emerging novel fertility preserving methods while there is still a chance of a successful pregnancy. The current proposal represents a comprehensive and novel investigation to assess measui fertility potential in adolescent and young adult cancer survivors. The aims are two fold: to compare existing and novel surrogate measures of fertility potential between young female cancer survivors and healthy controls, and to assess changes in existing and novel surrogate measures of fertility potential during and after chemotherapy in young cancer patients. Measures of fertility potential to be tested include ultrasound imaging, endocrine evaluation, and assessment of oxidative stress. This proposal will assist in establishing a protocol for evaluating ovarian reserve in female pedii cancer survivors. Specifically, the results of this proposal will serve as preliminary data for the establishment of a long term cohort study of pediatric cancer survivors to examine the association between these measures and pregnancy rates, pregnancy outcomes and the occurrence of premature menopause.

项目摘要 目前，美国最近有25万名儿童癌症幸存者 小儿肿瘤学的治疗进步导致儿童和年轻人的存活率更高 有恶性肿瘤。但是，尽管癌症疗法改善了长期生存，但此类治疗可能导致 生育潜力受损和最终的早产卵巢衰竭。促性毒性作用 化学治疗剂有充分的文献证明，特别是对于烷基化剂，例如环磷酰胺 并且似乎是剂量依赖的。但是，尽管降低的生殖潜力已被确认 多年来，关于下丘脑 - 垂体 - 基达功能的内分泌学的信息很少 在治疗之前，期间和之后，青少年和年轻人患有癌症。在不育环境中 几项临床测试，包括血清激素测量和卵巢的超声测量 已开发并通常用作评估女性的生育潜力的替代标记 有关治疗选择的咨询。另外，还有新的数据表明氧化应激的标记 可能反映卵巢衰老。但是，尚未确定这种卵巢功能测试可以检测到 在癌症治疗期间和之后，年轻女性癌症患者的生育能力降低。早期的 发现癌症幸存者生育潜力降低的发现将有助于确定 利用现有辅助生殖技术和新兴小说从积极的治疗中受益 生育能力保留方法虽然仍然有可能成功怀孕。 当前的提案代表了评估测量值的全面和新颖的研究 青少年和年轻成人癌症幸存者的生育潜力。目的是两个折：比较现有 和新颖的替代替代女性癌症幸存者与健康的生育潜力的衡量标准 对照，并评估现有和新颖的替代措施的变化，并在 年轻癌症患者化疗后。要测试的生育潜力的度量包括超声 成像，内分泌评估和氧化应激的评估。 该建议将有助于建立一项评估女性卵巢储备的协议 癌症幸存者。具体而言，该提案的结果将作为机构的初步数据 小儿癌症幸存者的长期队列研究，以检查它们之间的关联 措施和怀孕率，妊娠结局以及更年期过早的发生。