Adjuvant Tx for Early Testicular Cancer Does Not Harm Sperm
Adjuvant tx has no clinically significant long-term effect on total sperm number, concentration
WEDNESDAY, Feb. 27, 2019 (Pharmacist's Briefing) -- For clinical stage I testicular cancer (TC) patients, adjuvant treatment after orchiectomy has no long-term significant effect on sperm production, according to a study published online Feb. 25 in the Annals of Oncology.
Kristina Weibring, from the Karolinska Institute in Stockholm, and colleagues evaluated 182 stage I TC patients aged 18 to 50 years during 2001 to 2006 within five years of orchiectomy. Semen samples were delivered after orchiectomy and before further treatment and at six, 12, 24, 36, and 60 months (T0 to T60) after treatment completion. Testicular function was assessed based on measurements of total sperm number (TSN) and sperm concentration (SC). Four groups were identified based on treatment modality: radiotherapy (RT, 70 patients); one cycle of adjuvant bleomycin, etoposide, cisplatin, five-day regimen (62 patients); one cycle of adjuvant carboplatin (22 patients); and management by surveillance (28 patients).
The researchers identified a significant but transient drop in mean TSN and mean SC at T6 after RT in a cross-sectional analysis. No significant differences were noted in the other treatment groups, apart from a significant increase in mean SC at T12 compared with baseline. In 119 patients delivering three or more samples, over time, the TSN and SC values were stable.
"We offer patients sperm banking before orchiectomy as a number of patients may have low sperm counts before orchiectomy and remain so also after adjuvant treatment," the authors write.