Institute of Oncology, Davidoff Center, Rabin Medical Center, Petah-Tiqva, Israel.
Reproduction. 2012 Aug;144(2):153-63. doi: 10.1530/REP-12-0121. Epub 2012 May 31.
Seminal advances in anticancer therapy as well as supportive care strategies have led to improved survival rates, posing an emphasis on preserving an optimum quality of life after cancer treatment. This recognition has paved the way to an increasing research of long-term side effects, both clinical and preclinical and to an ongoing design of a supportive care system to evaluate and treat long-term adverse effects of anticancer treatments, including the impact on fertility. As with many adverse effects induced by anticancer treatments, the literature comprised mostly clinical data with regard to chemotherapy-induced gonadotoxicity, while understanding of the biological mechanism is lagging. The impact of anticancer treatments on female fertility depends on the women's age at the time of treatment, the chemotherapy protocol, the duration, and total cumulative dose administered. Several suggested mechanisms that underlie chemotherapy-induced gonadotoxicity have been described. This review illustrates the clinical evidence, as well as its supportive preclinical studies, while proceeding from the 'bedside to the bench work' and provides an insight to what lies behind chemotherapy-induced gonadotoxicity.
癌症治疗的重大进展以及支持性护理策略已经提高了生存率，这使得人们更加注重在癌症治疗后保持最佳的生活质量。这种认识为长期临床和临床前副作用的研究以及支持性护理系统的不断设计铺平了道路，以评估和治疗抗癌治疗的长期不良反应，包括对生育能力的影响。与许多由抗癌治疗引起的不良反应一样，文献中大多数是关于化疗引起的性腺毒性的临床数据，而对生物学机制的理解却滞后了。抗癌治疗对女性生育能力的影响取决于女性治疗时的年龄、化疗方案、持续时间和总累积剂量。已经描述了几个潜在的化疗引起性腺毒性的机制。本综述从“床边到实验台”的角度展示了临床证据及其支持性临床前研究，并深入探讨了化疗引起性腺毒性的背后原因。
