Recovery of sperm production after chemotherapy for osteosarcoma.
Marvin L. Meistrich,Sant P. Chawla,M. F. Da Cunha,S. L. Johnson,C. Plager,N. E. Papadopoulos,L. I. Lipshultz,Robert S. Benjamin +7 more
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TLDR
The risk of long‐term infertility from treatment with the PADIC regimen is low and the inclusion of additional drugs such as methotrexate, bleomycin, dactinomycin), or cyclophosphamide did not significantly affect the recovery of spermatogenesis.Abstract:
Because treatment with surgery and combination chemotherapy produces a high cure rate in young men with osteosarcoma, their subsequent reproductive function is an important concern. Semen analyses of osteosarcoma patients, therefore, were performed before, during, and after treatment with the PADIC regimen consisting of cisplatin, Adriamycin (doxorubicin), and dacarbazine or, in some cases, the PADIC regimen plus additional drugs. Results showed that semen volume was not affected and that sperm motility was reduced only during treatment. Although nearly all patients were rendered azoospermic during treatment, sperm production resumed in 30 of 32 patients examined at least 2 years after treatment. Analysis with correction for censored data indicates that, in 78% of treated men, sperm counts will return to more than 10 million/ml. The percentage of men whose sperm counts recovered to normal was lower for those receiving cisplatin dosages greater than or equal to 600 mg/m2; no trends were observed with Adriamycin and dacarbazine dosages. The inclusion of additional drugs such as methotrexate, bleomycin, dactinomycin, or cyclophosphamide (less than 4 g/m2) did not significantly affect the recovery of spermatogenesis. We conclude that the risk of long-term infertility from treatment with the PADIC regimen is low.read more
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Journal ArticleDOI
The biology of infertility: research advances and clinical challenges
Martin M. Matzuk,Dolores J. Lamb +1 more
TL;DR: The past six years have witnessed a virtual explosion in the identification of gene mutations or polymorphisms that cause or are linked to human infertility, but translation of these findings to the clinic remains slow, however, as do new methods to diagnose and treat infertile couples.
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Biology and Therapeutic Advances for Pediatric Osteosarcoma
TL;DR: The authors review the state of the art management for patients with osteosarcoma in North America and Europe including the use of limb-salvage procedures and reconstruction as well as discuss the etiologic and biologic factors associated with tumor development.
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Spermatogenesis After Cancer Treatment: Damage and Recovery
Sacha J Howell,Stephen M Shalet +1 more
TL;DR: The vast majority of men receiving procarbazine-containing regimens for the treatment of lymphomas are rendered permanently infertile, whereas treatment with doxorubicin hydrochloride (Adriamycin), bleomycin, vinblastine, and dacarbazine appears to have a significant advantage, with a return to normal fertility in the vastmajority of patients.
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Gonadal damage from chemotherapy and radiotherapy.
Simon J Howell,Stephen M Shalet +1 more
TL;DR: Currently, sperm banking remains the only proven method in men, although hormonal manipulation to enhance the recovery of spermatogenesis and cryopreservation of testicular germ cells are possibilities for the future.
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Effects of chemotherapy and radiotherapy on spermatogenesis in humans.
TL;DR: Most of the newer biologic targeted therapies seem to have only modest effects, mostly on the endocrine aspects of the male reproductive system; however, their effects when used in combination with cytotoxic agents have not been well studied.
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