BACKGROUND: The enormous differences in semen quality following cisplatin-based combination chemotherapy reported in previous studies may be caused by differences in the cisplatin dosages. PATIENTS AND METHODS: We examined thirty-three patients treated with conventional-dose PEB (cisplatin 20 mg/m2 x 5, q3w, etoposide 100 mg/m2 x 5 q3w and bleomycin 15 mg/m2 q1w) and 21 patients treated with high-dose PEB (cisplatin 40 mg/m2 x 5 q3w, etoposide 200 mg/m2 x 5 q3w and bleomycin 15 mg/m2 q1w). RESULTS: The sperm density was significantly higher (median 5.83 mill/ml) in the conventionally-treated group than in the group of high-dose-treated patients (median 0.005 mill/ml) (p = 0.008). Azoospermia was present in 19% of the conventionally- and in 47% of the high-dose-treated patients. All patients treated with a cumulative cisplatin dose above 600 mg/m2 had severe oligospermia or azoospermia. Serum values of basal follicle-stimulating hormone (FSH) (median 27.2 iu/l vs. 15.2 iu/l) and stimulated FSH (median 57.7 iu/l vs. 28.4 iu/l) were significantly higher in the high-dose group than in the conventionally-treated group. No differences could be detected in basal or stimulated testosterone or in luteinizing hormone in serum. CONCLUSION: In patients treated with PEB for testicular cancer, we found strong evidence that the impairment of spermatogenesis is dose-dependent.
BACKGROUND: The enormous differences in semen quality following cisplatin-based combination chemotherapy reported in previous studies may be caused by differences in the cisplatin dosages. PATIENTS AND METHODS: We examined thirty-three patients treated with conventional-dose PEB (cisplatin 20 mg/m2 x 5, q3w, etoposide 100 mg/m2 x 5 q3w and bleomycin 15 mg/m2 q1w) and 21 patients treated with high-dose PEB (cisplatin 40 mg/m2 x 5 q3w, etoposide 200 mg/m2 x 5 q3w and bleomycin 15 mg/m2 q1w). RESULTS: The sperm density was significantly higher (median 5.83 mill/ml) in the conventionally-treated group than in the group of high-dose-treated patients (median 0.005 mill/ml) (p = 0.008). Azoospermia was present in 19% of the conventionally- and in 47% of the high-dose-treated patients. All patients treated with a cumulative cisplatin dose above 600 mg/m2 had severe oligospermia or azoospermia. Serum values of basal follicle-stimulating hormone (FSH) (median 27.2 iu/l vs. 15.2 iu/l) and stimulated FSH (median 57.7 iu/l vs. 28.4 iu/l) were significantly higher in the high-dose group than in the conventionally-treated group. No differences could be detected in basal or stimulated testosterone or in luteinizing hormone in serum. CONCLUSION: In patients treated with PEB for testicular cancer, we found strong evidence that the impairment of spermatogenesis is dose-dependent.
Authors: Daniel M Green; Wei Liu; William H Kutteh; Raymond W Ke; Kyla C Shelton; Charles A Sklar; Wassim Chemaitilly; Ching-Hon Pui; James L Klosky; Sheri L Spunt; Monika L Metzger; DeoKumar Srivastava; Kirsten K Ness; Leslie L Robison; Melissa M Hudson Journal: Lancet Oncol Date: 2014-09-16 Impact factor: 41.316
Authors: M Brydøy; S D Fosså; O Klepp; R M Bremnes; E A Wist; T Bjøro; T Wentzel-Larsen; O Dahl Journal: Br J Cancer Date: 2012-11-20 Impact factor: 7.640