STUDIES OF TESTICULAR FUNCTION AFTER TREATMENT FOR TESTICULAR TUMORS
III. The Influence of Chemotherapy on Pituitary-Testicular Axis in Patients with Testicular Tumor
1985 Volume 76 Issue 7 Pages 1035-1041
Details
1985 Volume 76 Issue 7 Pages 1035-1041
It is important to preserve the testicular function of patients with testicular tumor after treatment. Testicular function after chemotherapy was endocrinologically investigated in the present study.
1. The levels of LH, FSH and testosterone in the blood were sequentially determined in patients with testicular tumor before, during and after chemotherapy. In the majority of the patients given a high-dose chemotherapy such as PVB (CDDP, VBL, BLM) therapy, the levels of LH and FSH were extraordinarily high after the therapy, but they tended to decrease gradually with time. In contrast, a low-dose prophylatic chemotherapy such as VAB (ACD, VCR, BLM) therapy was associated with the high levels in only few cases.
2. The Gn-RH stimulation test after chemotherapy showed a high LH response rate to Gn-RH and delayed normalization of the level in all four patients given a high-dose chemotherapy such as PVB therapy. Three of six patients given a prophylatic chemotherapy such as VAB therapy also showed similar abnormalities after the high-dose chemotherapy.
3. The hCG stimulation test was performed after chemotherapy. The response rate of hCG was low in all four patients given a high-dose chemotherapy such as PVB therapy and in three of five patients given a prophylatic chemotherapy such as VAB therapy.
The results obtained in the present study were summarized as follows.
1. The spermatogenesis of patients with testicular tumor revealed a tendency to be impaired by chemotherapy. This was particularly dominant in those given a high-dose chemotherapy such as PVB therapy.
2. Considered from the high level of LH and the response patterns of Gn-RH and hCG stimulation tests after chemotherapy, it is presumed that the reserve function of Leydig cell was decreased by chemotherapy, particularly in patients given a high-dose chemotherapy such as PVB therapy.
