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  • Traitement Anticancereux, Fonction de Reprodution et Sexualtite
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Chimiothérapie anticancéreuse et fertilité masculine

Cancer chemotherapy and fertility in men

Andrologie volume 5, pages 458–464 (1995)Cite this article

Resume

Parmi les agents anti-cancéreux, ceux qui interagissent directement avec l'ADN sont les plus toxiques pour les cellules de la lignée germinale. L'atteinte de ces cellules est essentiellement le fait des agents alkylants dont la toxicité est dose-dépendante. La rapidité et la qualité de récupération de la spermatogénèse est essentiellement fonction de la sévérité de l'atteinte des spermatogonies souches. Les études expérimentales conduites chez la souris et le rat ont permis de progresser dans la connaissance des mécanismes de la toxicité germinale des agents cytotoxiques, mais ces données ne sont pas toujours superposables à celles observées en clinique. Les études ont essentiellement été conduites chez les patients porteurs de tumeurs germinales du testicule ou de maladie de Hodgkin. Du fait de leur curabilité potentielle et de leur fréquente survenue chez le sujet jeune, elles représentent en effet les situations cliniques dans lesquelles il est essentiel d'essayer de préserver la fertilité du sujet. Le choix des protocoles chimiothérapiques les moins toxiques pour la lignée germinale, à résultat thérapeutique équivalent, est actuellement un moyen de réduire au maximum le risque d'azoospermie définitive. Ce risque n'est cependant jamais nul justifiant le recours systématique à l'auto-conservation de gamètes avant toute chimiothérapie chez un sujet susceptible de développer un projet de paternité.

Abstract

Among the chemotherapeutic drugs, those interacting with DNA are the more toxic for the germinal epithelium. Alkylating agents heavily affect these germ cells with a dose dependant toxicity. The incidence of recovery and length of time to recover normal spermatogenesis depend on the extent of damage to earlier forms of the germ cells. Experimental studies conducted on rodents improved the knowledge of the toxic mechanism of the drugs, which are in fact quite different of the clinical situation. Preservation of fertility is essential in hodgkin's disease and testis cancer because of their high curability rate and their incidence in young people.

References

  1. BERTHELSEN J.G., SKAKKEBAEK N.E.: Gonadal function in men with testis cancer. Fertil Steril, 1983, 39: 68–75.

    PubMed  CAS  Google Scholar 

  2. BERTHELSEN J. G.: Testicular cancer and fertility. Int J Androl, 1987, 10: 371–380.

    Article  PubMed  CAS  Google Scholar 

  3. BONNADONNA G., SANTORO A., VIVIANI S., et al: Treatment strategies for Hodgkin's disease. Semin Hematol, 1988, 25 (2): 51–57.

    Google Scholar 

  4. BRÄMSWING J.H., HEIMES U., HEIERMANN E., et al: The effects of different cumulative doses of chemotherapy on testicular function. Cancer, 1990, 65: 1298–1302.

    Article  Google Scholar 

  5. BUCHANAN J.D., FAIRLEY K.F., BARRIE J.U.: Return on spermatogenesis after stopping cyclophosphamide therapy. Lancet, 1972, 1: 568–569.

    Google Scholar 

  6. CHAPMAN R.M., STUCLIFFE S.B., REES L.H., et al: Cyclic combination chemotherapy and gonadal function. Reprospective study in males. Lancet, 1979, 1: 285–289.

    Article  PubMed  CAS  Google Scholar 

  7. CHAPMAN R.M., SUTCLIFFE S.M., MALPAS J.C.: Male gonadal dysfunction in Hodgkin's disease. A prospective study. JAMA, 1981, 245: 1323–1328.

    Article  PubMed  CAS  Google Scholar 

  8. CHEVIAKOFF S., CALAMERA J.C., MORGENFELD M., et al: Recovery of spermatogenesis in patients with lymphoma after treatment with chlorambucil. J Reprod Fertil, 1973, 33: 155–157.

    Article  PubMed  CAS  Google Scholar 

  9. COSTABILE R.A.: The effects of cancer and cnacer therapy on male reproductive function. J Urol, 1993, 149: 1327–1330.

    PubMed  CAS  Google Scholar 

  10. DA CUNHA M.F., MEISTRICH M.L., RIED H.L., et al: Active sperm production after cancer chemotherapy with doxorubicin. J Urol, 1983, 130: 927–930.

    PubMed  Google Scholar 

  11. da CUNHA M.F., MEISTRICH M.L., FULLER L.M., et al: Recovery of spermatogenesis after treatment of Hodgkin's disease: limiting dose of MOPP chemotherapy. J Clin Oncology, 1984, 2: 571–577.

    Google Scholar 

  12. FAIRLEY K.F., BERRIE J.U., JONHSON W.: Sterility and testicular atrophy related to cyclophosphamide therapy. Lancet, 1972, 1: 568–569.

    Article  PubMed  CAS  Google Scholar 

  13. FOSSA S.D., KLEPP O., AAKVAAG A., et al: Testicular function after combined chemotherapy for metastatic testicular cancer. Int J Androl, 1980, 3: 59–65.

    Article  PubMed  CAS  Google Scholar 

  14. FOSSA S.D., OUS S., ABYHOLM T., et al: Post treatment fertility in patients with testicular cancer. I Influence of retroperitoneal lymph node dissection on ejaculatory potency. Br J Urol, 1985, 57: 204–209.

    Article  PubMed  CAS  Google Scholar 

  15. FOSSA S.D., OUS S., ABYHOLM T., et al: Post treatment fertility in patients with testicular cancer. II Influence of cis-platin based combination chemotherapy and of retroperitoneaal surgery on hormone and sperm cell production. Br J Urol, 1985, 57: 210–214.

    Article  PubMed  CAS  Google Scholar 

  16. HANSEN S.W., BERTHELSEN J.C., von der MAASE H.: Long term fertility and Leydig cell function in patients treated for germ cell cancer with cisplatin, vinblastine, and bleomycin versus surveillance. J Clin Oncology, 1990, 8: 1695–1698.

    CAS  Google Scholar 

  17. KOPF-MAIER P.: Effects of carboplatin on the testis. A histological Study. Cancer Chemotherapy Pharmacol, 1992, 29 (3): 227–235.

    Article  CAS  Google Scholar 

  18. KREUSER E.D., HARSCH U., HETZEL W.D., et al: Chronic gonadal toxicity in patients with testicular cancer after chemotherapy. Eur J Cancer Clin Oncology, 1986, 22: 289–294.

    Article  CAS  Google Scholar 

  19. KREUSER E.D., XIROS N., HETZEL W.D., et al: Reproductive and endocrine gonadal capacity in patients treated with COPP chemotherapy for Hodgkin's disease. J Cancer Res Clin Oncology, 1987, 113: 260–266.

    Article  CAS  Google Scholar 

  20. LEITNER S.P., BOSL G.L., BAJOURNAS D.: Gonadal dysfunction in patients treated for metastatic germ cell tumors. J Clin Oncology, 1986, 4: 1500–1505.

    CAS  Google Scholar 

  21. MARINA S., BARCELO P.: Permanent sterility after immunosuppressive therapy. Int J Androl, 1979, 2: 6–13.

    Article  Google Scholar 

  22. MARTIN du PAN R.C., CAMPANA A.: Physiopathology of spermatogenic arrest. Fertil-Steril, 1993 Déc, 60 (6): 937–946.

    PubMed  CAS  Google Scholar 

  23. MEISTRICH M.L., FINCH M., da CUNHA M.F., et al: Damaging effects of fourteen chemotherapeutic drugs on mouse testis cells. Cancer Res, 1982, 42: 122–131.

    PubMed  CAS  Google Scholar 

  24. MEISTRICH M.L.: Relation ship between spermatogonial stem cell survival and testis fucntion after cytotoxic therapy. Br J Cancer, 1986, 53 (suppl VII): 89–101.

    Google Scholar 

  25. MEISTRICH M.L., CHAWLA S.P., da CUNHA M.F., et al: Recovery of sperm production after for chemotherapy osteosarcoma. Cancer, 1989, 63: 2115–2123.

    Article  PubMed  CAS  Google Scholar 

  26. MEISTRICH M.L.: Effects of chemotherapy and radiotherapy on spermatogenesis. Eur Urol, 1993, 23: 136–142.

    PubMed  CAS  Google Scholar 

  27. NIJMAN J.M., SCHRAFFORDT K.H., KREMER J., et al: Gonadal function after surgery and chemotherapy in men with stage II and III non seminomatous testicular tumors. J Clin Oncology, 1987, 5: 651–666.

    CAS  Google Scholar 

  28. PRYSANT R.M., MEISTRICH M.L., WILSON G.W., et al: Long-term reduction in sperm count after chemotherapy with and without radiation therapy for non-hodgkin's lymphomas. J Clin Oncol, 1993, 11 (2): 239–247.

    Google Scholar 

  29. QURESHI M.A., GOLDSMITH H.J., PENNINGTON J.H., et al: Cyclophosphamide therapy and sterility. Lancet, 1972, ii: 1290–1291.

    Article  Google Scholar 

  30. RICHTER P., CALAMERA J.C., MARGENFELD M.C., et al: Effects of chlorambucil on spermatogenesis in the human with malignant lymphoma. Cancer, 1970, 23: 1026–1030.

    Article  Google Scholar 

  31. ROESER H.P., STOCKS A.E., SMITH A.J.: Testicular damage due to cytoloxic drugs and recovery after cessation of therapy. Aust NZ J Med, 1978, 8: 250–254.

    CAS  Google Scholar 

  32. ROTH B.J., GREIST A., KUBILIS P.S., et al: Cisplatin-base combination chemotherapy for disseminated germ cell tumors; long term follow-up. J Clin Oncology, 1988, 6: 1239–1247

    CAS  Google Scholar 

  33. SHAMBERGER R.G., ROSENBERG S.A., SIEPP C.A., et al: Effects of high dose metotrexate and vincristine on ovarian and testicular functions in patients undergoing postoperative adjuvant treatment of osteosarcoma. Cancer Treat Rep, 1981, 65: 739–746.

    PubMed  CAS  Google Scholar 

  34. SHERINS R.J.: Gonadal Dysfunction. in Principes and practice of Oncology, V.T. de VITA, Lippincott Ed. Fourth edition, 1993: pp 2395–2404.

  35. TSENG A., KESSLER R., FREIHA F., et al: Male fertility before and after treatment of testicular cancer (abstr). Proc Am Soc Clin Oncology, 1984, 24: 161.

    Google Scholar 

  36. VILAR O.: Effects of cytostatic drugs on human testicular function. in: Male fertility and sterility, MANCINI R.E., MARTINI L.; Edition Academic Press, 1974: pp 423–440.

  37. VIVIANI S., SANTORO A., RAGNI G., et al: Gonadal toxicity after combination chemotherapy for Hodgkin's disease comparative results of MOPP versus ABVD. Eur J Cancer Clin Oncology, 1985, 21 (5): 601–605.

    Article  CAS  Google Scholar 

  38. WAXMAN J.H.X., TERRY Y.A., WRIGLEY P.F.M., et al: Gonadal function in Hodgkin's disease: long term follow up of chemotherapy. Br Med J, 285: 1612–1613.

  39. WHITEHEAD E., SHALET S.M., BLACKLEDGE G., et al: The effects of Hodgkin's disease and combination chemotherapy on gonodal function in the adulte male. Cancer, 1982, 49: 418–422.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Département d'Oncologie Médicale, Centre Claudius Regaud 20, 24 rue du Pont Saint-Pierre, 31052, Toulouse

    C. Chevreau

  2. Service d'Hématologie, Clinique Dieulafoy Hôpital de Purpan, Place du Docteur Baylac, 31059, Toulouse

    F. Huguet

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Chevreau, C., Huguet, F. Chimiothérapie anticancéreuse et fertilité masculine. Androl. 5, 458–464 (1995). https://doi.org/10.1007/BF03034529

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Basic and Clinical Andrology

ISSN: 2051-4190