Table 1.
Gonadotoxic risk associated with chemotherapy agents in women [13,14,15,17,18,22,23,24,25,27,54,55,56,57,58,59,60]. This table contains examples and is not a complete list.
| High Risk (>80%) |
Intermediate Risk (20–80%) | Low/Very Low Risk (<20%) | Unknown Risk | |
|---|---|---|---|---|
| Alkylating Agents | ||||
| Cyclophosphamide | ✓ | |||
| Carmustine | ✓ | |||
| Ifosfamide | ✓ | |||
| Busulfan | ✓ | |||
| Chlorambucil | ✓ | |||
| Melphalan | ✓ | |||
| Procarbazine | ✓ | |||
| Nitrogen mustard | ✓ | |||
| Antimetabolites | ||||
| Cytarabine | ✓ | ✓ | ||
| Methotrexate | ✓ | |||
| Mercaptopurine | ✓ | |||
| Fluorouracil | ✓ | |||
| Gemcitabine | ✓ | |||
| Antimitotic Cytostatics | ||||
| Vinblastine | ✓ | ✓ | ||
| Vincristine | ✓ | |||
| Taxanes | ✓ | ✓ | ||
| Anti-tumor Antibiotics | ||||
| Bleomycin | ✓ | ✓ | ||
| Dactinomycin | ✓ | |||
| Daunorubicin | ✓ | |||
| Doxorubicin | ✓ | ✓ | ||
| Epirubicin | ✓ | |||
| Mitomycin | ✓ | |||
| Topo-isomerase Inhibitors | ||||
| Etoposide | ✓ | |||
| Irinotecan | ✓ | |||
| Platinum-based Drugs | ||||
| Cisplatin | ✓ >600 mg/m2 |
✓ <600 mg/m2 |
||
| Carboplatin | ✓ | ✓ | ||
| Oxaliplatin | ✓ | ✓ | ||
| Combinations | ||||
| CMF (6 cycles) * | ✓ >40 years old |
✓ 30–39 years old |
✓ <30 years old |
|
| CEF (6 cycles) * | ✓ >40 years old |
✓ 30–39 years old |
✓ <30 years old |
|
| CAF (6 cycles) * | ✓ >40 years old |
✓ 30–39 years old |
✓ <30 years old |
|
| AC (4 cycles) * | ✓ >40 years old |
✓ <40 years old |
||
| EC (4 cycles) * | ✓ >40 years old |
✓ <40 years old |
||
| ABVD * | ✓ | |||
| CHOP (4–6 cycles) * | ✓ | |||
| TAC * | ✓ | |||
| BEACOPP * | ✓ | |||
| FOLFOX * | ✓ | |||
| Anthracycline/ cytarabine |
✓ | |||
| EURAMOS * | ✓ | ✓ | ||
| EuroEWING 12 * | ✓ |
* Abbreviations: CMF, cyclophosphamide, methotrexate and fluorouracil. CEF, cyclophosphamide, epirubicin and fluorouracil. CAF, cyclophosphamide, doxorubicin and fluorouracil. AC, doxorubicin and cyclophosphamide. EC, epirubicin and cyclophosphamide. ABVD, doxorubicin, bleomycin, vinblastine and dacarbazine. CHOP, cyclophosphamide, doxorubicin, vincristine and prednisone. FEC, 5-fluorouracil, epirubicin and cyclophosphamide. TAC, docetaxel, doxorubicin and cyclophosphamide. BEACOPP, bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisolone. FOLFOX, fluorouracil, leucovorin and oxaliplatin. Euramos is a protocol for osteosarcoma consisting of methotrexate, cisplatin and doxorubicin. EuroEWING12 is a protocol for Ewing sarcoma consisting of different combinations of vincristine, ifosfamide, doxorubicin, etoposide, actinomycin D and cyclophosphamide.