Viviani S, Ragni G, Santoro A, Perotti L, Caccamo E, Negretti E, Valagussa P, Bonadonna G
Division of Medical Oncology, Istituto Nazionale Tumori, Milan, Italy.
Eur J Cancer. 1991;27(11):1389-92. doi: 10.1016/0277-5379(91)90017-8.
Over a 7-year period, semen analysis was performed in 92 male patients with Hodgkin's disease prior to therapy. In 67% of patients semen revealed a decreased chance for fertility (i.e. oligozoospermia, asthenozoospermia and/or teratozoospermia). The mean basal levels of follicle-stimulating hormone (FSH), luteinising hormone, testosterone and prolactin were in the normal range. In 77 patients in complete remission after alternating MOPP/ABVD (mechlorethamine, vincristine, procarbazine, prednisone; doxorubicin, bleomycin, vinblastine, dacarbazine), testicular function was assessed. 87% of patients were azoospermic, 9% had semen abnormalities and only 4% were normospermic. Recovery of spermatogenesis was documented in only 17 of 42 (40%) reassessed patients after a median time of 27 months and was generally not affected by pretreatment sperm quality. After chemotherapy, the mean value of FSH [20.45 (S.E. 1.7) mUI/ml] was significantly superior compared with that of the mean pretreatment values. No difference was documented in the mean testosterone and prolactin values tested before and after treatment. Our findings indicate that, of patients with Hodgkin's disease, about half are affected by hypogonadism before starting chemotherapy. By utilising alternating MOPP/ABVD, persistent testicular dysfunction was documented in half of the patients.
在7年期间，对92例霍奇金病男性患者在治疗前进行了精液分析。67%的患者精液显示生育机会降低（即少精子症、弱精子症和/或畸形精子症）。促卵泡激素（FSH）、黄体生成素、睾酮和催乳素的平均基础水平在正常范围内。对77例在交替使用MOPP/ABVD（氮芥、长春新碱、丙卡巴肼、泼尼松；阿霉素、博来霉素、长春花碱、达卡巴嗪）后完全缓解的患者的睾丸功能进行了评估。87%的患者无精子症，9%有精液异常，只有4%为正常精子症。在中位时间27个月后，42例重新评估的患者中只有17例（40%）记录到精子发生恢复，且通常不受治疗前精子质量的影响。化疗后，FSH的平均值[20.45（标准误1.7）mUI/ml]显著高于治疗前的平均值。治疗前后测试的睾酮和催乳素平均值无差异。我们的研究结果表明，在霍奇金病患者中，约一半在开始化疗前受到性腺功能减退的影响。通过使用交替MOPP/ABVD，一半的患者记录到持续性睾丸功能障碍。
