Incidence of chemotherapy-induced amenorrhea in premenopausal women treated with adjuvant folfox for colorectal cancer Journal Article

  

Authors:	Cercek, A.; Siegel, C. L.; Capanu, M.; Reidy-Lagunes, D.; Saltz, L. B.
Article Title:	Incidence of chemotherapy-induced amenorrhea in premenopausal women treated with adjuvant folfox for colorectal cancer
Abstract:	Background: Studies indicate that the incidence of young women diagnosed with colorectal cancer is rising, thus there is an increasing number of female colorectal cancer survivors of premenopausal and child-bearing age. Adjuvant FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin) chemotherapy is the most widely used standard treatment for stage III and high-risk stage II colon cancer. We evaluated the incidence of FOLFOX-induced amenorrhea in women age 50 and younger treated with adjuvant therapy for colorectal cancer. Patients and Methods: A search of pharmacy records identified 119 women age 50 or younger who received adjuvant FOLFOX chemotherapy at Memorial Sloan-Kettering for stage II or III colorectal cancer from January 2002 and January 2011. Eligible patients were mailed an anonymous questionnaire. The returned surveys were reviewed and the results tallied. Results: Seventy-three patients returned the questionnaire. Twenty-four patients were excluded from analysis: 19 were treated with pelvic radiotherapy, 2 patients had undergone bilateral oophorectomy, 2 had a hysterectomy, and 1 stopped menstruating before diagnosis. Forty-nine patient responses were analyzed. In total, 41% (n = 20) experienced amenorrhea during chemotherapy. Sixteen percent had persistent amenorrhea 1 year after completion of chemotherapy. The incidence of amenorrhea during chemotherapy trended higher in patients aged older than 40 compared with patients aged 40 and younger (59% vs. 31% [P =.075]). There was no statistically significant difference in persistent amenorrhea between the 2 age groups (24% vs. 13%; P =.42). Conclusion: In this retrospective series, there appears to be a trend toward FOLFOX induced amenorrhea during chemotherapy increasing with age. Twenty-four percent of women older than the age of 40 were found to have persistent amenorrhea after FOLFOX therapy. Because of the small sample size, the study is underpowered to detect a statistically significant difference between older and younger patients. Prospective studies are planned to further characterize the effect of FOLFOX on early menopause and fertility. © 2013 Elsevier Inc. All rights reserved.
Keywords:	adult; major clinical study; fluorouracil; cancer adjuvant therapy; hysterectomy; colorectal cancer; ovariectomy; retrospective study; high risk patient; folinic acid; colon cancer; premenopause; oxaliplatin; drug induced disease; young women; amenorrhea; folfox chemotherapy; menses; chemotherapy induced amenorrhea
Journal Title:	Clinical Colorectal Cancer
Volume:	12
Issue:	3
ISSN:	1533-0028
Publisher:	Elsevier Inc.
Date Published:	2013-09-01
Start Page:	163
End Page:	167
Language:	English
DOI:	10.1016/j.clcc.2013.04.007
PROVIDER:	scopus
PUBMED:	23871161
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84883150155&partnerID=40&md5=f060e038c1b69d1de980482ca6fecd70
Notes:	--- - "Export Date: 1 October 2013" - "CODEN: CCCLC" - "Source: Scopus"

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