Gonadal function after surgery and chemotherapy in men with stage II and III nonseminomatous testicular tumors.
Gonadal function after surgery and chemotherapy in men with stage II and III nonseminomatous testicular tumors.
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II 期和 III 期非精原细胞睾丸肿瘤男性手术和化疗后的性腺功能。
DOI：
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发表时间：
1987
影响因子：
45.3
通讯作者：
D. Sleijfer
中科院分区：
文献类型：
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作者：
J. Nijman;H. Koops;J. Kremer;D. Sleijfer
对54例经联合化疗（顺铂、长春碱、博来霉素[PVB]）和手术（化疗后半睾丸切除术、腹膜后淋巴结清扫或腹膜后残余肿瘤切除）的弥散性非半细胞瘤睾丸肿瘤患者，以及17例一期肿瘤仅行半睾丸切除术患者的性腺功能进行了研究。化疗患者在治疗结束后2年血浆睾酮水平维持在正常下限，黄体生成素（LH）水平持续升高。促卵泡激素（FSH）水平也保持显著升高，但在2年后呈下降趋势。对25例患者进行精液分析；在其他患者中，18名患者没有顺行射精，8名患者接受了输精管切除术，3名患者没有配合。治疗前，72%的患者出现azoo或少精症；停止化疗2年后，48%的患者有azoo或少精症，28%的患者有超过60x10(6)个精子/mL。然而，有趣的是，无精子症患者的比例从4%增加到28%。在这项研究的过程中，发生了8次怀孕；一个以早期自然流产告终；其他七次怀孕的过程并不复杂。七个健康的孩子出生了。在17例仅行半睾丸切除术的I期肿瘤患者中，也观察了2年的睾酮、LH和FSH水平；直到治疗后2年，睾酮水平仍然较低，FSH水平仍然高于正常水平。未受影响的性腺中间质细胞的不足似乎是导致血液中激素浓度改变的原因。
The gonadal functions were studied in 54 patients with disseminated nonseminomatous testicular tumors who had been subjected to combination chemotherapy (cisplatin, vinblastine, and bleomycin [PVB]) and surgery (hemiorchiectomy, retroperitoneal lymph node dissection or removal of retroperitoneal residual tumor after chemotherapy) and in 17 patients with a stage I tumor subjected to hemiorchiectomy exclusively. In the patients treated with chemotherapy, the plasma testosterone levels remained at the lower limit of normal and the luteinizing hormone (LH) levels remained elevated for 2 years after completion of treatment. The follicle-stimulating hormone (FSH) levels also remained significantly elevated, but showed a tendency to decrease after 2 years. Semen analysis was performed in 25 patients; of the other patients, 18 had no antegrade ejaculation, eight had undergone a vasectomy and three patients did not cooperate. Before treatment, 72% of the patients showed azoo- or oligozoospermia; 2 years after discontinuation of the chemotherapy, 48% had azoo- or oligozoospermia while 28% had more than 60 X 10(6) spermatozoa/mL. However, interestingly the proportion of patients with azoospermia had increased from 4% to 28%. In the course of this study, eight pregnancies occurred; one ended in an early spontaneous abortion; the other seven pregnancies ran an uncomplicated course. Seven healthy children were born. In 17 patients with a stage I tumor treated by hemiorchiectomy only, the testosterone, LH and FSH levels were also observed for 2 years; until 2 years after treatment, the testosterone levels remained lower and the FSH levels remained higher than normal. Insufficiency of the Leydig's cells in the unaffected gonad appeared to be responsible for the altered hormone concentrations in the blood.
维持治疗在播散性睾丸癌中的作用。
DOI：
10.1056/nejm198109243051303
发表时间：
1981
期刊：
The New England journal of medicine
影响因子：
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作者：
Einhorn,LH;Williams,SD;Troner,M;Birch,R;Greco,FA
通讯作者：
Greco,FA