Hansen S W, Berthelsen J G, von der Maase H
Department of Oncology, Finsen Institute, Rigshospitalet, Copenhagen, Denmark.
J Clin Oncol. 1990 Oct;8(10):1695-8. doi: 10.1200/JCO.1990.8.10.1695.
Fertility and Leydig cell function were investigated in 31 patients previously treated for nonseminomatous testicular cancer. Twenty-two patients with metastatic cancer had received cisplatin-based chemotherapy, and the median follow-up was 64 months (range, 42 to 100 months). Nine patients without metastases were treated with orchiectomy alone, and follow-up in this group was a median of 61 months (range, 40 to 77 months). None of the patients have relapsed and retroperitoneal lymph node dissection was not performed in any patient. Both the concentration of spermatozoa and the volume of the remaining testis are significantly reduced in patients who had previously received chemotherapy when compared with patients treated with orchiectomy alone (P less than .05). There were no significant differences between groups when comparing morphology, motility, and penetration of the spermatozoa. Subclinical Leydig cell dysfunction with normal testosterone and elevated luteinizing hormone (LH) was observed in one patient (11%) treated with orchiectomy alone, while 59% of the patients who had received chemotherapy had elevated LH (P less than .05). We conclude that cisplatin-based chemotherapy leads to a persistent impairment of fertility and Leydig cell function in the majority of patients with testicular cancer.
对31例既往接受过非精原细胞瘤性睾丸癌治疗的患者的生育能力和睾丸间质细胞功能进行了研究。22例转移性癌患者接受了以顺铂为基础的化疗，中位随访时间为64个月（范围42至100个月）。9例无转移的患者仅接受了睾丸切除术，该组的中位随访时间为61个月（范围40至77个月）。所有患者均未复发，且无一例患者进行了腹膜后淋巴结清扫术。与仅接受睾丸切除术的患者相比，既往接受过化疗的患者精子浓度和剩余睾丸体积均显著降低（P<0.05）。比较精子形态、活力和穿透能力时，两组之间无显著差异。仅接受睾丸切除术的1例患者（11%）出现了亚临床睾丸间质细胞功能障碍，睾酮正常但黄体生成素（LH）升高，而接受化疗的患者中有59%的患者LH升高（P<0.05）。我们得出结论，以顺铂为基础的化疗导致大多数睾丸癌患者的生育能力和睾丸间质细胞功能持续受损。
