R. M. Rentea1, A. S. Poola1, J. M. Fulbright3, S. D. St. Peter1, S. R. Shah4 1Children’s Mercy Hospital- University Of Missouri Kansas City,Pediatric Surgery,Kansas City, MO, USA 3Children’s Mercy Hospital- University Of Missouri Kansas City,Hematology/Medical Oncology,Kansas City, MO, USA 4Texas Children’s Hospital,Pediatric Surgery,Houston, TX, USA
Introduction: Pediatric patients with pelvic tumors often necessitate a multidisciplinary treatment approach involving pediatric surgeons, pediatric oncologists, and radiation oncologists. Current guidelines recommend discussion of fertility preservation in pre- and post-pubertal patients with cancer. The objective of this review is to assess the number of female patients with pelvic tumors receiving radiation therapy, and the proportion that undergo measures for fertility preservation.
Methods: A retrospective review was conducted of all female patients treated with pelvic tumors at an academic children’s hospital from January 1, 2003 – December 31, 2012. Data collected included tumor type, tumor location, treatment regimen, and discussion of fertility preservation.
Results: A total of 47 female patients with pelvic tumors were identified. Fifteen (31.9%) of these patients underwent pelvic radiation therapy. The distribution of the types of pelvic tumors for patients that underwent pelvic radiation therapy is shown in Table 1. Three of the patients received radiation therapy for palliative treatment. Of the remaining 12 female patients receiving radiation therapy, three (25%) were pre-pubertal. Two patients (16.7%) had documentation of a discussion of fertility preservation measures prior to radiation therapy. Both of these patients were post-pubertal, and neither pursued fertility preservation measures. Five patients (41.7%) were evaluated by endocrinology after radiation therapy, diagnosed with ovarian failure, and placed on hormone therapy.
Conclusion: This 10-year review of female patients that underwent radiation therapy for pelvic tumors at an academic children’s hospital demonstrated < 17% of patients have documentation of a discussion of fertility preservation measures. Based on these findings we have established a protocol for discussing and documenting the impact of pelvic radiation on fertility and available measures for fertility preservation. We anticipate this standardized protocol will improve compliance with current guidelines.
