The authors surveyed practicing US radiation oncologists who are members of ASTRO via an online two-minute, 25 question assessment. Respondents’ characteristics, and perceived patient infertility rates were analyzed for association with treatment recommendations. Among 6,967 surveys, the authors received 353 responses (5.1%), among which 23% consider themselves experts in this disease space. The majority (84%) of respondents recommend observation as a default strategy. Roughly half of radiation oncologists routinely advised fertility assessment for patients prior to observation or chemotherapy, and 74% routinely did so prior to adjuvant radiotherapy. Eighty-three percent of respondents felt that 10-30% of patients are infertile following orchiectomy. When treating patients, 80% routinely use clamshell scrotal shielding. Responders with higher perceived infertility rates were more likely to recommend fertility assessment/sperm banking, and those who routinely advised fertility assessment were more likely to use clamshell shielding during treatment. A limitation of this study is the low survey response rate (5%).
The authors concluded that results of their survey of practicing radiation oncologists in the US revealed a gap in the knowledge of fertility issues in men with stage 1 testicular seminoma and frequency of patient education and fertility counseling. Encouragingly, most radiation oncologists responding to the survey recommend surveillance in the stage I seminoma setting, given that many patients will never relapse and avoid potentially toxic therapy .
Presented by: Carl M Post, BS University of Nebraska Medical Center, Omaha, NE
Co-Authors: Aditya Jain, Catherine Degnin, Yiyi Chen, Michael Ellis Craycraft, Arthur Hung, Jerry Jeff Jaboin, Charles R. Thomas, Timur Mitin; University of Nebraska Medical Center, Omaha, NE; Oregon Health & Science University, Portland, OR; Testicular Cancer Society, Cincinnati, OH; Oregon Health and Science University, Portland, OR
Written by: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre, @zklaassen_md at the 2018 American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium, February 8-10, 2018 - San Francisco, CA
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