As survival rates in childhood cancer progress significantly, health outcomes in adulthood are pivotal to quality of life (QoL). Female patients undergoing chemotherapy and radiation for childhood cancer may experience adverse effects such as gonadotoxicity-related ovarian insufficiency. Ovarian tissue cryopreservation (OTC) is well studied in adults, but has only recently started to be explored in an effort to preserve fertility in young patients with childhood cancer. This systematic review aims to critically highlight contemporary outcomes of cryopreservation in female pediatric cancer patients. A systematic search was conducted in PubMed, Embase, and Web of Science databases to identify English-language full text articles and abstracts published between 2004 and 2022 describing cryopreservation among female children (0–21 years old) with cancer. Abstracts and full-text articles were screened for inclusion. Subsequently, data from eligible studies was extracted and analyzed. Descriptive statistics were utilized to estimate overall outcomes of cryopreservation. Of 104 abstracts and 34 full-text articles, 12 studies were included. Data was collected from 7 world countries and involved some 612 pediatric and adolescent patients with malignant disease. Most common cancers included hematological malignant disease (81%), CNS nervous system malignant tumors (56%), and sarcomas (39%). Of the 6 studies with full reporting, OTC was undertaken in 501 patients, and 5.9% (30/501) of these patients underwent ovarian tissue transplantation (OTT). After OTT, 27 patients desired pregnancy and 33% (9/27) became pregnant. Six of these 9 patients (67%) had live births. Preliminary analysis showed that OTC has been successfully performed but not yet studied thoroughly in pediatric cancer patients in a longitudinal manner. This study has further shown that cryopreservation outcomes are mainly reported among adult patients living in high income countries, demonstrating a crucial need for long-term outcome studies focused on pediatric and prepuberal OTC, subsequent OTT, and potential pregnancy. This work is considered critical to aid standardize recommendations of fertility preservation in childhood cancer patients and to better inform the efficacy of these procedures to benefit patients in world nations of all fiscal income levels. Level III.

中文翻译：

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儿童癌症中女性生育能力冷冻保存的结果：系统评价

随着儿童癌症生存率显着提高，成年期的健康结果对于生活质量 (QoL) 至关重要。接受儿童癌症化疗和放疗的女性患者可能会出现不良反应，例如与性腺毒性相关的卵巢功能不全。卵巢组织冷冻保存 (OTC) 在成人中得到了充分研究，但最近才开始探索，以努力保护患有儿童癌症的年轻患者的生育能力。本系统综述旨在批判性地强调当代女性儿科癌症患者冷冻保存的结果。在 PubMed、Embase 和 Web of Science 数据库中进行了系统检索，以识别 2004 年至 2022 年间发表的描述患有癌症的女童（0-21 岁）冷冻保存的英文全文文章和摘要。摘要和全文文章均经过筛选以纳入。随后，提取并分析了合格研究的数据。利用描述性统计来估计冷冻保存的总体结果。在 104 篇摘要和 34 篇全文文章中，纳入了 12 项研究。数据收集自世界 7 个国家，涉及约 612 名患有恶性疾病的儿童和青少年患者。最常见的癌症包括血液系统恶性肿瘤（81%）、中枢神经系统恶性肿瘤（56%）和肉瘤（39%）。在有完整报告的 6 项研究中，501 名患者接受了 OTC，其中 5.9%（30/501）的患者接受了卵巢组织移植（OTT）。 OTT 后，27 名患者希望怀孕，33% (9/27) 怀孕了。这 9 名患者中有 6 名 (67%) 活产。初步分析表明，OTC 已在儿科癌症患者中成功进行，但尚未进行深入的纵向研究。这项研究进一步表明，冷冻保存结果主要发生在生活在高收入国家的成年患者中，这表明迫切需要针对儿科和青春期前 OTC、随后的 OTT 和潜在妊娠进行长期结果研究。这项工作被认为对于帮助标准化儿童癌症患者生育力保留的建议至关重要，并更好地告知这些程序的有效性，以使世界上所有财政收入水平国家的患者受益。三级。