Huyghe Eric, Matsuda Tomohiro, Daudin Myriam, Chevreau Christine, Bachaud Jean-Marc, Plante Pierre, Bujan Louis, Thonneau Patrick
Human Fertility Research Group, Paule de Viguier Hospital, Toulouse, France.
Cancer. 2004 Feb 15;100(4):732-7. doi: 10.1002/cncr.11950.
Patients with testicular cancer have an excellent survival rate, and fertility is one of the main concerns of survivors. The authors investigated fertility status after treatment for testis cancer in long-term survivors.
Four hundred fifty-one consecutive patients with testicular cancer (1979-1999) from health facilities in the French Midi-Pyrenees region were enrolled. Testis tumors were classified according to the Royal Marsden Hospital Classification. Fertility status was assessed by means of a mailed, standardized questionnaire focused on reproductive events that occurred before and after treatment. Of 451 patients with germ-cell tumors, information concerning fertility was obtained in 446 patients (98.9%). The follow-up was at least 3 years.
Before they were diagnosed with testicular cancer, 91.2% of patients who had tried to get their partners pregnant had succeeded, compared with 67.1% of patients after treatment. Radiotherapy had a much more deleterious effect on fertility compared with chemotherapy alone. Furthermore, cumulative conception rates (log-rank test) for patients who received radiotherapy were significantly lower compared with the rates for patients who received chemotherapy.
The outcome of this study, which included the largest series reported to date, showed that fertility in patients with testicular cancer decreased by 30% after treatments and that radiotherapy seemed to have the most deleterious effect on fertility.
睾丸癌患者的生存率很高，生育能力是幸存者主要关注的问题之一。作者调查了长期存活的睾丸癌患者治疗后的生育状况。
纳入了来自法国南部-比利牛斯地区医疗机构的451例连续的睾丸癌患者（1979年至1999年）。睾丸肿瘤根据皇家马斯登医院分类法进行分类。通过邮寄标准化问卷评估生育状况，该问卷聚焦于治疗前后发生的生殖事件。在451例生殖细胞肿瘤患者中，446例患者（98.9%）提供了有关生育能力的信息。随访时间至少为3年。
在被诊断为睾丸癌之前，91.2%试图让伴侣怀孕的患者成功受孕，而治疗后这一比例为67.1%。与单纯化疗相比，放疗对生育能力的损害更大。此外，接受放疗患者的累积受孕率（对数秩检验）显著低于接受化疗的患者。
本研究纳入了迄今为止报道的最大样本量，结果显示睾丸癌患者治疗后的生育能力下降了30%，放疗似乎对生育能力的损害最大。
