Kowalska A
Ze Swietokrzyskiego Centrum Onkologii, Kielcach.
Pol Tyg Lek. 1993;48(25-26):572-5.
The past three decades have shown the increasing success of chemotherapy as the treatment of malignancies. This therapeutic success has focused attention on the associated gonadal toxicity. Cytotoxic agents may induce infertility and endocrine disfunction. Data for analysis were provided by studies on gonadal function after chemotherapy for: Hodgkin's disease, acute lymphocytic leukemia, non-Hodgkin's lymphoma, breast cancer; renal disease, bone-marrow transplantation. The likelihood of developing chemotherapy-induced damage depended on the chemotherapeutic regimen and prescribed dose, illness, sex and degree of gonadal activity at the time of treatment. Despite of the high frequency of chemotherapy-induced gonadal damage its prevention has received a little attention. LH-RHA and oral contraceptive therapy and testosterone have been tested to a limited extent of gonadal toxicity. Usually in male endocrine disfunction of testis does not need to be treated because it is moderate and does not cause any clinical symptoms. In female hormonal substitution seems to be necessary to decrease unpleasant feelings connected with menopause induced by chemotherapy. Further investigations should considered use of new cytotoxic agents without gonadal toxicity or use of new drugs which can better protect gonadal function.
在过去三十年中，化疗作为恶性肿瘤的治疗手段取得了越来越大的成功。这种治疗上的成功使得人们将注意力集中在相关的性腺毒性上。细胞毒性药物可能会导致不孕和内分泌功能障碍。用于分析的数据来自于对以下疾病化疗后性腺功能的研究：霍奇金病、急性淋巴细胞白血病、非霍奇金淋巴瘤、乳腺癌；肾脏疾病、骨髓移植。发生化疗诱导损伤的可能性取决于化疗方案和规定剂量、疾病、性别以及治疗时性腺的活跃程度。尽管化疗诱导性腺损伤的发生率很高，但其预防却很少受到关注。促性腺激素释放激素类似物（LH-RHA）、口服避孕药疗法以及睾酮在性腺毒性方面仅进行了有限程度的测试。通常，男性睾丸的内分泌功能障碍无需治疗，因为其程度较轻且不会引起任何临床症状。对于女性而言，似乎有必要进行激素替代治疗，以减轻与化疗引起的绝经相关的不适感受。进一步的研究应考虑使用无性腺毒性的新型细胞毒性药物，或者使用能够更好地保护性腺功能的新药。
