Читать книгу Assisted Reproduction Techniques - Группа авторов - Страница 164

Over the last three decades advances in high dose chemotherapy and radiotherapy (RT) have resulted in an increase in the survival rates of most forms childhood cancers. In Europe, current estimates are that there are nearly 500,000 childhood cancer survivors with a median age between 25 and 29 years. Approximately 10,000 new survivors are added to these numbers on a yearly basis. The U.S. cancer statistics report of cancer incidence, mortality and survival from the American Cancer Society has also confirmed a sustained increase in the 5‐year relative survival rate of children and adolescents treated for all cancers combined [1]. Survival rates have thus undergone remarkable improvements from 58% during the mid‐1970s to 83% during 2007‐2013 for children and from 68% to 84% for adolescents.

Newer radiation techniques, including intensity‐modulated radiation therapy (IMRT) and proton RT, have improved normal tissue‐sparing effects. Improved fertility preservation methods have also been developed in the field of reproductive medicine [2]. About three in four young cancer survivors without children not only expressed a desire to have children but were also concerned about reduction of fertility and possible treatment‐related pregnancy complications and neonatal outcomes [3]. For these reasons, we can expect to see an increasing number of patients with previous pelvic irradiation seeking fertility services.