The effects of radiotherapy and chemotherapy on female reproduction
The effects of radiotherapy and chemotherapy on female reproduction
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DOI：
10.1093/humupd/7.6.535
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发表时间：
2001-11-01
影响因子：
13.3
通讯作者：
Nugent, D
中科院分区：
文献类型：
--
作者：
Meirow, D;Nugent, D
大剂量化疗和放射治疗从根本上提高了年轻癌症患者的长期存活率，但这些治疗的主要副作用是卵巢衰竭和不孕。了解治疗引起的卵巢衰竭的风险和概率对于患者和医生做出最符合患者利益的知情选择至关重要。该综述介绍了卵巢损伤和失败的数据暴露在放疗，化疗和消融治疗。根据已发表的文献，根据患者的年龄、治疗方案以及一些常见恶性肿瘤的诊断来评估风险。这些患者中的许多人在治疗后不会立即进行绝育，而是会过早绝经。为了防止绝育，必须在盆腔照射前进行卵巢移位。除了在化疗前对卵巢组织和胚胎进行冷冻保存外，还讨论了垂体-卵巢下调可能的保护作用。介绍了放化疗导致原始卵泡损伤的机制，以及细胞凋亡信号通路在破坏中的作用。增加对这些机制的了解可能有助于确定潜在的有效抑制物，可以阻断原始卵泡破坏的途径，降低卵巢失败率。
High dose chemotherapy and radiotherapy have radically increased long-term survival of young cancer patients, but major side effects of these treatments are ovarian failure and infertility. Knowledge of the risks and probabilities of ovarian failure caused by treatment is crucial for patients and physicians in order to make informed choices that will best serve patients' interests. This review presents data on ovarian damage and failure following exposure to radiotherapy, chemotherapy and ablative therapy. The risk is evaluated from the published literature according to patient's age, treatment protocol and also according to the diagnosis of some common malignancies. Many of these patients will not be sterilized immediately following treatment, but will suffer from premature menopause. In order to prevent sterilization, ovarian transposition before pelvic irradiation is mandatory. Besides cryopreservation of ovarian tissue and embryos before administration of chemotherapy, the possible protective effect of pituitary-ovarian down-regulation is discussed. The mechanism of primordial follicles damage induced by radio/chemotherapy is presented as well as the role of apoptosis signalling pathways underlying destruction. Increased knowledge of these mechanisms could help to identify potential effective inhibitors that can block the path of primordial follicles destruction and reduce ovarian failure rate.