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  • Traitement Anticancereux, Fonction de Reproduction et Sexualtite
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Protection gonadique contre les effets des chimiothérapies et/ou radiothérapies chez l'homme: applications cliniques

Protection of the testis against side effects of cancer therapy: clinical trials

Resume

Les effets délétères des chimiothérapies et radiothérapies sur la spermatogenèse touchent des hommes jeunes en âge de procréer. Au delà de l'autoconservation de sperme obligatoire avant la mise en route du traitement anticancéreux, des protocoles ayant pour objectifs de protéger la spermatogenèse pourraient être proposés chez l'homme. Les analogues du GnRh ou les stéroïdes ont été utilisés dans ce but chez l'homme. Cette revue bibliographique résume les différentes études publiées et en discute les limites. A la lumière des travaux expérimentaux réalisés chez l'animal et de la mise au point de nouvelles molécules, des perspectives de protection de la spermatogenèse sont proposées.

Abstract

The damage effects of cytotoxic chemotherapy or radiotherapy were particularly important on spermatogenesis and fertility of young patients who were treated for cancer. The cryopresevation of semen is obligatory in these patients before starting therapy. In animals several protosols have been tried to protect the testis against chemotherapy and radiotherapy with positive results. In men, seven clinical trials have been done to preserve the testis by means of hormonal treatment. Five used GnRh agonist, one medroxyprogesterone acetate and the last one testosterone enanthate. These patients where treated with chemotherapy or/and radiotherapy. None of these clinical trials had any protective effect on testis function. The results of these studies, and the reasons of this failure are discussed, and, based on animals experiments and recent drogues availability new protosols of spermatogenesis preservation are suggested such as use of steroids, GnRh antagonist or testis hypothermia.

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Bujan, L., Mieusset, R. Protection gonadique contre les effets des chimiothérapies et/ou radiothérapies chez l'homme: applications cliniques. Androl. 5, 504–511 (1995). https://doi.org/10.1007/BF03034535

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