Ovarian function in female survivors after multimodal Ewing sarcoma therapy

Area of Science:

• Oncology
• Reproductive Medicine
• Pediatric Hematology/Oncology

Background:

• Advances in cancer care increase survival rates for young women with Ewing sarcoma (ES).
• Assessing ovarian function and infertility risk in ES survivors is crucial for reproductive health.
• Multimodal therapy for ES poses significant risks to ovarian function.

Purpose of the Study:

• To analyze ovarian function in female survivors of Ewing sarcoma across different age groups.
• To identify risk factors for infertility in young women treated for ES.
• To inform fertility preservation strategies for ES patients.

Main Methods:

• Retrospective multiinstitutional study of 27 female ES survivors.
• Classification of patients based on treatment: chemotherapy (CHT) with/without pelvic radiation (pRT), and autologous hematopoietic stem cell rescue (aHSCT).
• Analysis of ovarian function and fertility outcomes post-treatment.

Main Results:

• 67% of survivors developed premature ovarian insufficiency (POI) at a median follow-up of 5.7 years.
• Pelvic radiation (RR 3.9) and aHSCT (RR 2.4) were significant risk factors for POI.
• 37% of patients exhibited symptoms of premature menopause.

Conclusions:

• Multimodal therapy for ES frequently leads to premature ovarian insufficiency.
• Informed consent regarding reproductive potential and fertility preservation is essential.
• Individualized fertility preservation strategies should be considered for ES patients at risk.