Incidence of FOLFOX induced amenorrhea in women age 40 and younger with colorectal cancer.

Abstract

567 Background: The effects of oxaliplatin-based chemotherapy on female fertility are largely unknown. Studies have indicated that the incidence of young women diagnosed with colorectal cancer is on the rise, thus there is an increasing number of female colorectal cancer survivors of child-bearing age. Adjuvant FOLFOX chemotherapy is the most widely used standard treatment for stage III and high- risk stage II colon cancer. The objective of this analysis was to evaluate the incidence of amenorrhea as a crude measure of potential fertility in women age 40 and younger treated with FOLFOX. Methods: A search of computerized pharmacy records identified 45 women age 40 or younger who received adjuvant FOLFOX chemotherapy at Memorial Sloan-Kettering for stage II or III colorectal cancer from January 2002 and January 2009. Fourteen patient s had received pelvic radiation and 3 developed metastatic disease and were thus ineligible. A total of 28 patients were eligible and were mailed an anonymous questionnaire asking their age at time of diagnosis and specific questions regarding their menses pre-, during, and post-chemotherapy. The returned surveys were reviewed and the results tallied. Results: Of the 28 patients that met the eligibility criteria and were mailed the survey 16 (57%) returned the questionnaire. One patient had undergone bilateral oophorectomy and was ineligible. The majority of patients were 31-35 years old (range 21-40). All but one patient had regular pretreatment menses. Of the 15 eligible patients, 7 maintained their usual menses throughout chemo, 3 noted a change in their menses, and 6 lost their cycles. Only 1 (6%) did not regain her menstrual cycle 6 months after stopping chemotherapy. Conclusions: In this small retrospective study, the incidence of amenorrhea in young women treated with FOLFOX chemotherapy is quite low. Prospective studies are planned to more accurately characterize the impact of FOLFOX on female fertility. [Table: see text]