Colpi G M, Contalbi G F, Nerva F, Sagone P, Piediferro G
Andrology Service, Ospedale San Paolo, Polo Universitario, Via Di Rudinì 8, 20142 Milan, Italy.
Eur J Obstet Gynecol Reprod Biol. 2004 Apr 5;113 Suppl 1:S2-6. doi: 10.1016/j.ejogrb.2003.11.002.
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.
癌症生存率的提高使患有恶性肿瘤的年轻患者出现了不孕问题。本研究的目的是回顾目前关于化疗（CT）和放疗（RT）对睾丸和血液系统肿瘤患者睾丸功能影响的相关知识。基于顺铂的方案治疗睾丸肿瘤会导致暂时性无精子症；高剂量（400 - 600 mg/m²）时可能会造成永久性损伤。烷化剂对血液系统肿瘤治疗非常有效，但对生精上皮极具危险性，损伤可能是不可逆的。精子无法耐受高于6 Gy的辐射剂量。高于15 Gy的剂量会损伤睾丸间质细胞。已证明A - 精原细胞在化疗和放疗后能够存活，并且最近在动物模型中已开发出用于治疗后移植的恢复方法。年轻肿瘤患者在治疗前进行不孕咨询是必要的。冷冻保存是保护生育能力的最佳选择。
