Schilsky R L, Lewis B J, Sherins R J, Young R C
Ann Intern Med. 1980 Jul;93(1):109-14. doi: 10.7326/0003-4819-93-1-109.
Since the introduction of antineoplastic chemotherapy, lasting clinical remissions have been obtained for many patients with acute lymphoblastic leukemia, Hodgkin's disease, gestational trophoblastic tumors, and other malignancies. With this therapeutic success there have been concerns about persistent or delayed toxicities of cancer chemotherapy that may become clinically significant for long-term survivors. Gonadal toxicity and infertility occur in many men, women, and children treated with antineoplastic drugs. In this paper we review the clinical syndromes of chemotherapy-related gonadal toxicity and discuss how particular drug classes, doses, or combinations correlate with the degree of gonadal injury and with the potential for recovery of function. Further, we examine how drug effects on germ cell production and endocrine function vary with the age of the patient at the time of treatment. Finally, we comment on the need for long-term prospective studies of fertility, teratogenesis, and mutagenesis in patients receiving cancer chemotherapy.
自从引入抗肿瘤化疗以来，许多急性淋巴细胞白血病、霍奇金病、妊娠滋养细胞肿瘤及其他恶性肿瘤患者都获得了持久的临床缓解。随着这种治疗上的成功，人们开始关注癌症化疗的持续性或迟发性毒性，这些毒性对于长期存活者可能具有临床意义。接受抗肿瘤药物治疗的许多男性、女性和儿童都会出现性腺毒性和不育。在本文中，我们回顾了化疗相关性腺毒性的临床综合征，并讨论了特定的药物类别、剂量或联合用药如何与性腺损伤程度以及功能恢复潜力相关联。此外，我们研究了药物对生殖细胞生成和内分泌功能的影响如何随治疗时患者的年龄而变化。最后，我们评论了对接受癌症化疗患者的生育力、致畸作用和诱变作用进行长期前瞻性研究的必要性。
