PDF(Pubmed)
Abstract：
OBJECTIVE: As a further step to elucidate the actual diverse spectrum of oncofertility practices for breast cancer around the globe, we present and discuss the comparisons of oncofertility practices for breast cancer in limited versus optimum resource settings based on data collected in the Repro-Can-OPEN Study Part I & II.
METHODS: We surveyed 39 oncofertility centers including 14 in limited resource settings from Africa, Asia & Latin America (Repro-Can-OPEN Study Part I), and 25 in optimum resource settings from the United States, Europe, Australia and Japan (Repro-Can-OPEN Study Part II). Survey questions covered the availability of fertility preservation and restoration options offered to young female patients with breast cancer as well as the degree of utilization.
RESULTS: In the Repro-Can-OPEN Study Part I & II, responses for breast cancer and calculated oncofertility scores showed the following characteristics: (1) higher oncofertility scores in optimum resource settings than in limited resource settings especially for established options, (2) frequent utilization of egg freezing, embryo freezing, ovarian tissue freezing, GnRH analogs, and fractionation of chemo- and radiotherapy, (3) promising utilization of oocyte in vitro maturation (IVM), (4) rare utilization of neoadjuvant cytoprotective pharmacotherapy, artificial ovary, and stem cells reproductive technology as they are still in preclinical or early clinical research settings, (5) recognition that technical and ethical concerns should be considered when offering advanced and innovative oncofertility options.
CONCLUSIONS: We presented a plausible oncofertility best practice model to guide oncofertility teams in optimizing care for breast cancer patients in various resource settings.
METHODS: We surveyed 39 oncofertility centers including 14 in limited resource settings from Africa, Asia & Latin America (Repro-Can-OPEN Study Part I), and 25 in optimum resource settings from the United States, Europe, Australia and Japan (Repro-Can-OPEN Study Part II). Survey questions covered the availability of fertility preservation and restoration options offered to young female patients with breast cancer as well as the degree of utilization.
RESULTS: In the Repro-Can-OPEN Study Part I & II, responses for breast cancer and calculated oncofertility scores showed the following characteristics: (1) higher oncofertility scores in optimum resource settings than in limited resource settings especially for established options, (2) frequent utilization of egg freezing, embryo freezing, ovarian tissue freezing, GnRH analogs, and fractionation of chemo- and radiotherapy, (3) promising utilization of oocyte in vitro maturation (IVM), (4) rare utilization of neoadjuvant cytoprotective pharmacotherapy, artificial ovary, and stem cells reproductive technology as they are still in preclinical or early clinical research settings, (5) recognition that technical and ethical concerns should be considered when offering advanced and innovative oncofertility options.
CONCLUSIONS: We presented a plausible oncofertility best practice model to guide oncofertility teams in optimizing care for breast cancer patients in various resource settings.
摘要：
目标：进一步阐明全球范围内乳腺癌的不同生育实践，我们根据在Repro-Can-OPEN研究第I部分和第II部分中收集的数据,介绍并讨论了在有限资源环境中与最佳资源环境中对乳腺癌的肿瘤生育实践的比较.
方法：我们调查了39个生育中心，其中14个来自非洲的有限资源环境，亚洲和拉丁美洲(可开放研究第一部分)，和25个来自美国的最佳资源设置，欧洲,澳大利亚和日本（可开放研究第二部分）。调查问题涵盖了为年轻女性乳腺癌患者提供的生育力保护和恢复选择的可用性以及利用程度。
结果：在Repro-Can-OPEN研究第一和第二部分中，对乳腺癌的反应和计算的生育率得分显示出以下特征：（1）在最佳资源设置中比在有限的资源设置中更高的生育率得分，特别是对于既定的选择，（2）频繁利用卵子冷冻，胚胎冷冻,卵巢组织冷冻，GnRH类似物,化疗和放疗的分割，(3)有希望利用卵母细胞体外成熟(IVM)，（4）罕见的新辅助细胞保护药物治疗，人工卵巢,和干细胞生殖技术，因为它们仍处于临床前或早期临床研究环境中，（5）认识到在提供先进和创新的生育选择时应考虑技术和道德方面的问题。
结论：我们提出了一个合理的生育最佳实践模型，以指导生育团队在各种资源环境中优化乳腺癌患者的护理。
方法：我们调查了39个生育中心，其中14个来自非洲的有限资源环境，亚洲和拉丁美洲(可开放研究第一部分)，和25个来自美国的最佳资源设置，欧洲,澳大利亚和日本（可开放研究第二部分）。调查问题涵盖了为年轻女性乳腺癌患者提供的生育力保护和恢复选择的可用性以及利用程度。
结果：在Repro-Can-OPEN研究第一和第二部分中，对乳腺癌的反应和计算的生育率得分显示出以下特征：（1）在最佳资源设置中比在有限的资源设置中更高的生育率得分，特别是对于既定的选择，（2）频繁利用卵子冷冻，胚胎冷冻,卵巢组织冷冻，GnRH类似物,化疗和放疗的分割，(3)有希望利用卵母细胞体外成熟(IVM)，（4）罕见的新辅助细胞保护药物治疗，人工卵巢,和干细胞生殖技术，因为它们仍处于临床前或早期临床研究环境中，（5）认识到在提供先进和创新的生育选择时应考虑技术和道德方面的问题。
结论：我们提出了一个合理的生育最佳实践模型，以指导生育团队在各种资源环境中优化乳腺癌患者的护理。
