Testicular function following chemo-radiotherapy.
Improvements in cancer survival raise infertility issues in young patients suffering from malignancies. The aim of the study is to review current knowledge on the effect of chemotherapy (CT) and radiotherapy (RT) for testis and hematological neoplasms on testicular function. Cisplatin-based regimens for testis neoplasm induce temporary azoospermia; permanent damage can occur with high doses (400-600 mg/m(2)). Alkylating agents are very effective for hematological neoplasm therapy but extremely dangerous to germinal epithelium. Damage can be irreversible. Spermatozoa cannot tolerate irradiation doses higher than 6 Gy. Leydig cells are damaged by doses higher than 15 Gy. A-Spermatogonia have been shown to survive after CT and RT and their recovery for post-treatment graft has been recently developed in animal models. Infertility counselling before treatment in young oncological patients is mandatory. Cryopreservation is the best option for fertility protection.
Colpi
G M
GM
Andrology Service, Ospedale San Paolo, Polo Universitario, Via Di Rudinì 8, 20142 Milan, Italy. gmcolpi@yahoo.com
Contalbi
G F
GF
Nerva
F
F
Sagone
P
P
Piediferro
G
G
D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects; D015925:Cryopreservation; D019337:Hematologic Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D007248:Infertility, Male / Q000139:chemically induced / Q000209:etiology*; D007985:Leydig Cells / Q000187:drug effects / Q000528:radiation effects; D008297:Male; D011879:Radiotherapy Dosage; D012662:Semen Preservation; D012731:Sex Counseling; D013094:Spermatozoa / Q000187:drug effects / Q000528:radiation effects; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy / Q000628:therapy*
D000970:Antineoplastic Agents; D002945:Cisplatin