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\begin{document}

\title{Fertility Preservation in Pediatric Solid Tumors: A Report from the
Children's Oncology Group}



\author[1]{Kari Bjornard}%
\author[2]{Allison Close}%
\author[3]{Karen Burns}%
\author[2]{Josuah Chavez}%
\author[4]{Eric Chow}%
\author[5]{Lillian Meacham}%
\affil[1]{Indiana University Department of Pediatrics}%
\affil[2]{Helen DeVos Children’s Hospital}%
\affil[3]{Cincinnati Children's Hospital Medical Center Cancer and Blood Diseases Institute}%
\affil[4]{Fred Hutchinson Cancer Center}%
\affil[5]{Children's Healthcare of Atlanta Inc Aflac Cancer and Blood Disorders Center}%


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  \date{June 17, 2024}


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\begin{abstract}
Treatment for childhood solid tumors may lead to an increased risk for
gonadal dysfunction/infertility. Discussion of risk should occur at
diagnosis, any changes in therapy, and during survivorship. Gonadotoxic
therapies were abstracted from 32 Children's Oncology Group (COG) phase
III, frontline solid tumor protocols, in use from 2000-2022. Risk for
gonadal dysfunction/infertility was assessed based on gonadotoxic
therapies, sex, and pubertal status and assigned as \emph{minimal},
\emph{significant,} and \emph{high} following the Oncofertility
Consortium Pediatric Initiative Network (PIN) risk stratification. Most
protocols (65.6\%, 21/32) contained at least one therapeutic arm with a
\emph{high} level of increased risk. Solid tumor therapies present
challenges in risk stratification due to response-adjusted therapy and
the need to account for radiation field in the risk assessment. This
guide hopes to serve as a tool to assist in standardizing gonadotoxic
risk assessments across disciplines and improve referral for fertility
services and reproductive health counseling for patients receiving COG
based solid tumor therapy.%
\end{abstract}%



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\textbf{Hosted file}

\verb`ST COG How I approach PBC submit.docx`  available at \url{https://authorea.com/users/700205/articles/687173-fertility-preservation-in-pediatric-solid-tumors-a-report-from-the-children-s-oncology-group}

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