Lackner Jakob, Schatzl Georg, Koller Anke, Mazal Peter, Waldhoer Thomas, Marberger Michael, Kratzik Christian
Department of Urology, Medical University of Vienna, Vienna, Austria.
Urology. 2005 Aug;66(2):402-6. doi: 10.1016/j.urology.2005.03.050.
To investigate the influence of treatment for testicular cancer on the pituitary-gonadal axis and sexual function in long-time survivors after unilateral orchiectomy.
Blood was drawn from patients treated for testicular cancer during routine oncologic follow-up for measurement of luteinizing hormone, follicle-stimulating hormone, sexual hormone-binding globulin, testosterone, and bioavailable testosterone. Sexual function was evaluated using the International Index of Erectile Function 15-item (IIEF-15) questionnaire. Patients were grouped according to treatment: group 1 followed a surveillance strategy, group 2 received two cycles of carboplatin monotherapy, and group 3 underwent cisplatin, etoposide, and bleomycin chemotherapy.
No statistically significant difference was found in the serum hormonal levels among the three groups, and all hormonal levels were within the 95% confidence range, except for follicle-stimulating hormone. The median serum testosterone level was 3.5 ng/mL in group 1, 3.9 ng/mL in group 2, and 4.2 ng/mL in group 3. In group 1, the median IIEF-15 score was 64.0, and the median Erectile Function (EF) domain score was 28. The median scores in groups 2 and 3 were 62.5 for IIEF-15 and 27.5 for EF and 65.0 for IIEF-15 and 30.0 for EF, respectively. No correlation was found between testosterone level and IIEF-15 or EF score.
None of the treatments investigated had a significant influence on the serum hormonal levels in long-time survivors of testicular cancer. Patients undergoing chemotherapy have no greater risk of developing a hormonal disorder than those following a surveillance strategy, and therapy for testicular cancer is not a risk factor for erectile dysfunction.
探讨单侧睾丸切除术后长期存活的睾丸癌患者接受治疗对垂体 - 性腺轴及性功能的影响。
在常规肿瘤学随访期间，采集接受睾丸癌治疗患者的血液，检测促黄体生成素、促卵泡生成素、性激素结合球蛋白、睾酮及生物可利用睾酮。使用国际勃起功能指数15项问卷（IIEF - 15）评估性功能。患者按治疗方式分组：第1组采用监测策略，第2组接受两个周期的卡铂单药治疗，第3组接受顺铂、依托泊苷和博来霉素化疗。
三组血清激素水平差异无统计学意义，除促卵泡生成素外，所有激素水平均在95%置信区间内。第1组血清睾酮中位数水平为3.5 ng/mL，第2组为3.9 ng/mL，第3组为4.2 ng/mL。第1组IIEF - 15中位数评分为64.0，勃起功能（EF）领域中位数评分为28。第2组和第3组IIEF - 15中位数评分分别为62.5和65.0，EF中位数评分分别为27.5和30.0。睾酮水平与IIEF - 15或EF评分之间未发现相关性。
所研究的治疗方法对睾丸癌长期存活者的血清激素水平均无显著影响。接受化疗的患者发生激素紊乱的风险并不高于采用监测策略的患者，睾丸癌治疗并非勃起功能障碍的危险因素。
