Chronic gonadal toxicity in patients with testicular cancer after chemotherapy.
Forty-five patients with disseminated testicular cancer treated with cisplatin, vinblastine and bleomycin +/- adriamycin (PVB +/- A) were studied to establish the impact of chemotherapy on hormonal and reproductive functions. Data on FSH, LH, testosterone, prolactin, semen analyses and sexual functions were obtained before, during and 1-6 yr after chemotherapy. Mean LH, testosterone and prolactin levels were within normal limits before, during and after chemotherapy. Twenty per cent (4/20) of the patients revealed pathologically elevated FSH levels due to pretreatment gonadal dysfunction. Germinal aplasia occurred in all patients in the first year after chemotherapy, as 100% rendered azoospermic and 95% showed statistically significant elevated FSH values (P = 0.001). In the third year after chemotherapy 80% (8/10) of the patients showed normalization of FSH levels and 100% (7/7) recovery of sperm production but with a high degree of immotile sperms. Although these results emphasize the restitution of spermatogenesis in the third year after cessation of PVB-regimen, the minority of these patients fathered children, probably due to reduced sperm motility.
Kreuser
E D
ED
Harsch
U
U
Hetzel
W D
WD
Schreml
W
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001761:Bleomycin / Q000009:adverse effects; D002945:Cisplatin / Q000009:adverse effects; D004317:Doxorubicin / Q000009:adverse effects; D006728:Hormones / Q000097:blood; D006801:Humans; D007248:Infertility, Male / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013076:Sperm Count / Q000187:drug effects; D013736:Testicular Neoplasms / Q000188:drug therapy*; D013737:Testis / Q000187:drug effects*; D014747:Vinblastine / Q000009:adverse effects
D006728:Hormones; D001761:Bleomycin; D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin