Pm. Petersen et al., DOSE-DEPENDENT IMPAIRMENT OF TESTICULAR FUNCTION IN PATIENTS TREATED WITH CISPLATIN-BASED CHEMOTHERAPY FOR GERM-CELL CANCER, Annals of oncology, 5(4), 1994, pp. 355-358
Background: The enormous differences in semen quality following cispla
tin-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 bleomyci
n 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 q
1w). 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 do
se above 600 mg/m2 had severe oligospermia or azoospermia. Serum value
s 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 sign
ificantly higher in the high-dose group than in the conventionally-tre
ated group. No differences could be detected in basal or stimulated te
stosterone 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.