ESPE Abstracts (2016) 86 P-P2-387

Questionnaire Surveys Targeting Japanese Pediatric Endocrinologists Regarding Reproduction in Pediatric and Adolescent Cancer Patients

Yoko Miyoshia, Tohru Yorifujib, Reiko Horikawac, Ikuko Takahashid, Keisuke Nagasakie, Hiroyuki Ishigurof, Ikuma Fujiwarag, Junko Itoh, Susumu Yokoyac, Tsutomu Ogatai & Keiichi Ozonoa

aOsaka University Graduate School of Medicine, Osaka, Japan; bOsaka City General Hospital, Osaka, Japan; cNational Center for Child Health and Development, Tokyo, Japan; dAkita University Graduate School of Medicine, Akita, Japan; eNiigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; fIsehara Kyodo Hospital, Kanagawa, Japan; gTohoku University Hospital, Sendai, Japan; hToranomon Hospital, Tokyo, Japan; iHamamatsu University School of Medicine, Hamamatsu, Japan

Background: While existing guidelines recommend long-term follow-up of childhood cancer survivors (CCS), their fertility has not been clarified in Japan.

Objective and hypotheses: To address this issue, we organized a working panel to compile evidence from CCSs. The team consisted of various medical specialists in foundation hospitals.

Method: We had conducted the questionnaire surveys targeting pediatric endocrinologists regarding reproduction in pediatric and adolescent cancer patients in collaboration with the CCS committee of the Japanese Society for Pediatric Endocrinology (JSPE). The first survey was sent to 178 JSPE-certified councilors who were asked to self-evaluate their medical examinations (Clin Pediatr Endocrinol 2016). The second survey was sent to the physicians who had answered the experience with childbirth of their patients during the follow-up or fertility preservation before cancer therapy.

Results: A total of 151 responses (85%) were obtained in the first survey. A quarter of the respondents experienced some issues with gonadal and reproductive examinations. In the second survey response rate was 100% (39 respondents). A limited number of councilors had experience with childbirth of their survivors (27 answers: 16 male CCSs, 22 female CCSs). A few cases with premature birth or delivery problems were reported. There were 25 answers of experience with fertility preservation for 21 male and 17 female patients. Sixteen respondents had experience with sperm cryopreservation, and 10 respondents had experience with gonadal shielding before radiotherapy for male patients, whereas nine respondents had experience with gonadal shielding before radiotherapy for female patients. A few respondents had experience with ovarian cryopreservation (n=3), testicular (n=2) or ovarian tissue cryopreservation (n=4), ovarian transposition (n=4), or use of GnRH analog (n=7). These preservations were proposed from the physicians (21), parents (1), patient (1), and not available (4).

Conclusion: In this nationwide questionnaire survey, Japanese pediatric endocrinologists mentioned the necessity for inter-disciplinary communication among healthcare providers and the need for long-term follow-up study of reproduction in CCSs.