Lecomte P, de Meeus M C, Lorette G, Lansac J, Soutoul J H
J Gynecol Obstet Biol Reprod (Paris). 1981;10(6):597-602.
The authors have studied the toxicity of alkylating agents on the gonads in the light of three cases. The more frequent prescription of these products in chemotherapy when treating cases in Nephrology, Dermatology, Neurology and Ophthalmology as well as general systemic diseases, should make the doctor prescribing them look out for the risks that the reproductive function runs in their use. Although of course there is no valid discussion of the use of these drugs when life is at stake one should all the same, seeing how their efficacy is increasing and survival is becoming more likely, ask oneself about their bad effects on the gonads, and in particular when they are being used for less serious indications. The gonads are often attacked early and insidiously, the the effects on them often starting before the more spectacular secondary effects such as alopecia or neutropenia. A review of the literature brings to light the following : there is a more marked effect on the gonad when it is the testis than when it is the ovary, which seems to be progressively affected; the lesions become worse and increase according to the pubertal state of the male. As far as testicular damage is concerned, it seems debatable whether is is dose-related or related to the length of treatment, and the chances of recovery on stopping chemotherapy with alkylating agents seen to be overall poor. On the practical level the use of sperm banks may resolve some of the worries about later infertility. As far as women are concerned, the greater resistance of the ovary to the effects should make one careful to employ contraceptive measures which are necessary during and after treatment (for fear of teratogenicity).
作者根据三个病例研究了烷化剂对性腺的毒性。在肾病学、皮肤病学、神经病学、眼科学以及全身性疾病的治疗中，这些产品在化疗中的处方越来越频繁，这就要求开具这些药物的医生注意其使用过程中生殖功能所面临的风险。当然，在危及生命的情况下，对这些药物的使用不存在有效的争议，但鉴于它们的疗效在不断提高，患者存活的可能性也越来越大，人们仍应思考它们对性腺的不良影响，尤其是在用于不太严重的适应症时。性腺常常在早期就受到隐匿性攻击，其影响往往在诸如脱发或中性粒细胞减少等更明显的副作用出现之前就已开始。对文献的回顾揭示了以下情况：当性腺为睾丸时，其受到的影响比为卵巢时更为明显，卵巢似乎是逐渐受到影响；随着男性青春期状态的不同，损害会变得更严重且增多。就睾丸损伤而言，其是否与剂量相关或与治疗时长相关似乎存在争议，而且停止使用烷化剂化疗后恢复的可能性总体上较差。在实际操作层面，使用精子库可能会解决一些对日后不育的担忧。就女性而言，卵巢对这些影响的抵抗力较强，这就要求在治疗期间及之后谨慎采取避孕措施（以免产生致畸性）。
