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2000, Número 1

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Rev Med Hosp Gen Mex 2000; 63 (1)


Fertilidad y cáncer

Gerson R

Idioma: Español
Referencias bibliográficas: 43
Paginas: 30-40
Archivo PDF: 95.39 Kb.


RESUMEN

En los tratamientos contra el cáncer se ha logrado obtener los mejores resultados en niños, adolescentes y adultos jóvenes, pero cobrando un costo en la capacidad reproductiva. A mediano y largo plazos, los órganos y tejidos sanos, particularmente las gónadas, pueden ser afectados, con consecuencias negativas para la fertilidad. Cirugía, radioterapia y tratamiento sistémico pueden interferir con la capacidad reproductiva. La magnitud del daño por citotóxicos varía según agente, dosis y edad del paciente al momento del tratamiento. En la gónada masculina los esquemas de quimioterapia deterioran las células tallo germinales, mientras que las células de Leydig rara vez son afectadas por lo que se conserva la función androgénica; la espermatogénesis puede recuperarse en forma tardía. Con ciertos tumores las cuentas espermáticas se encuentran bajas aun antes del inicio del tratamiento. La interrupción de la función ovárica se registra en mujeres adultas y guarda relación con la dosis acumulada. En productos de embarazo de sobrevivientes de cáncer, no se ha documentado aumento en teratogénesis o mutagénesis. El embarazo después del cáncer mamario no presenta efectos adversos sobre la supervivencia. Hombres y mujeres jóvenes que deben ser tratados contra el cáncer, deberán ser alertados sobre la fertilidad y recibir apoyo para restaurar una vida sana. Desde su inicio, el plan terapéutico deberá intentar proteger las gónadas, preservar células germinales e incluir una consulta sobre programas de fertilidad asistida.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Bailar JC, Gornik HL. Cancer undefeated. N Engl J Med 1997; 336: 1569-1574.

  2. Kreuser ED. Impact of chemotherapy and radiation on gonadal and sexual functions in patients treated for malignant tumors. In: The 21st European Society for Medical Oncology. USA: Educational Book, 1996: 79-83.

  3. Averette HE, Boike GM, Jarrell MA. Effects of cancer chemotherapy on gonadal function and reproductive capacity. CA-A Cancer J Clin 1990; 40: 199-209.

  4. Myers SE, Schilsky RL. Prospects of fertility after cancer chemotherapy. Semin Oncol 1992; 19: 597-603.

  5. Ross JA, Severson RK, Pollock BH, Robison LL. Childhood cancer in the Unites States. Cancer 1996; 77: 201-207.

  6. Reaman GH, Bonfiglio J, Krailo M et al. Cancer in adolescents and young adults. Cancer 1993; 71 (suppl): 3206-3209.

  7. Bleyer WA. What can we learn about childhood cancer, from Cancer Statistics Review 1973-1988. Cancer 1993; 71: 3229-3236.

  8. Ferrell BR, Hassey Dow K. Quality of life among long-term cancer survivors. Oncology 1997; 11: 565-571.

  9. Sherins RJ. Gonadal Dysfunction. In: DeVita, Hellman, Rosemberg. Cancer principles and practice of oncology. 4th ed. Philadelphia: Lippincott, 1993: 2395-2406.

  10. Neglia JP, Nesbitt ME. Care and treatment of long term survivors of childhood cancer. Cancer 1993; 71: 3386-3391.

  11. Robison L. Issues in the consideration of intervention strategies in long term survivors of childhood cancer. Cancer 1993; 71: 3406-3410.

  12. Byrne J, Mulvihill JJ, Myers MH et al. Effects of treatment on fertility in long term survivors of childhood or adolescent cancer. N Engl J Med 1987; 317: 1315-1321.

  13. Aubier F, Flamant F, Brauner R et al. Male Gonadal function after chemotherapy for solid tumors in childhood. J Clin Oncol 1989; 7: 304-309.

  14. Kulkarni SS, Sastry K, Saikia TK et al. Gonadal function following ABVD therapy for Hodgkin’s Disease. Am J Clin Oncol (CCT) 1997; 20: 354-357.

  15. Buckley JD, Chard RL, Baehner RL et al. Improvement in outcome of children with acute nonlymphocytic leukemia. Cancer 1989; 63: 1459-1465.

  16. Cohen A, Van-Lint MT, Lavagetto A et al. Pubertal development and fertility in children after bone marrow transplantation. Bone Marrow Transplant 1991; 8 (suppl): 16-20.

  17. Chatterjee R, Goldstone AH. Gonadal damage and effects of fertility in adult patients with haematological malignancy undergoing stem cell transplantation. Bone Marrow Transplant 1996; 17: 5-11.

  18. Lampe H, Horwich A, Norman A et al. Fertility after chemotherapy for testicular germ cell cancers. J Clin Oncol 1997; 15: 2339-2345.

  19. Hansen ST, Berthelsen JG, van der Maase H. Long term fertility and Leydig cell function in patients treated for germ cell cancer with cisplatin, Vinblastine and bleomycin versus surveillance. J Clin Oncol 1990; 8: 1695-1698.

  20. Arai Y, Kawakita M, Okada Y, Yoshida O. Sexuality and fertility in long term survivors of testicular cancer. J Clin Oncol 1997; 15: 1444-1448.

  21. Lange PH, Narayan P, Vogelzang J et al. Return of fertility after treatment for nonseminomatous testicular cancer: Changing concepts. J Urol 1983; 129: 1131-1135.

  22. Rieker PP, Fitzgerald EM, Kalish LA. Adaptive behavioral responses to potential infertility among survivors of testis cancer. J Clin Oncol 1990; 8: 347-355.

  23. Rivkees SA, Crawford JD. The relationship of gonadal activity and chemotherapy induced gonadal damage. JAMA 1988; 259: 2123-2125.

  24. Koyama H, Wada T, Nishizawa Y et al. Cyclophosphamide-induced ovarian failure and its therapeutic significance in patients with breast cancer. Cancer 1977; 39: 1403-1409.

  25. Ross DP, Davis TE. Ovarian function in patients receiving adjuvant chemotherapy for breast cancer. Lancet 1977; 4: 1174-1176.

  26. Saarto T, Blomqvist C, Välimäki M et al. Chemical castration induced by adjuvant cyclophosphamide, methotrexate and fluoracil chemotherapy causes rapid bone loss that is reduced by clodronate: A randomized study in premenopausal breast cancer patients. J Clin Oncol 1997; 15: 1341-1347.

  27. Gershenson DM. Menstrual and reproductive function after treatment with combination chemotherapy for malignant ovarian germ cell tumors. J Clin Oncol 1988; 6: 270-275.

  28. Retsas S, Mackenzie H, Mohith A. Fertility after prolonged chemotherapy for metastatic malignant disease. Lancet 1996; 347-687.

  29. Nicholson HS, Byrne J. Fertility and pregnancy after treatment for cancer during childhood or adolescence. Cancer 1993; 71: 3392-3339.

  30. Reichman BS, Green KB. Breast cancer in young women: effect of chemotherapy on ovarian function, fertility and birth defects. Monogr Natl Cancer Inst 1994; 16: 125-129.

  31. Hassey Dow K, Harris JR, Callista R. Pregnancy after breast-conserving surgery and radiation therapy for breast cancer. Monongr Natl Cancer Inst 1994; 16: 131-137.

  32. Green DM, Zevon MA, Lowrie G. Congenital anomalies in children of patients who received chemotherapy for cancer in childhood and adolescence. NEJM 1991; 325: 141-146.

  33. Velentgas P, Daling JR, Malone KE et al. Pregnancy after breast carcinoma. Cancer 1999; 85: 2424-2432.

  34. von Schoultz E, Johansson H, Wilkin N, Rutqvist LE. Influence of prior and subsequent pregnancy on breast cancer prognosis. J Clin Oncol 1995; 13: 430-434.

  35. Collichio FA, Agnello R, Staltzer J. Pregnancy after breast cancer: from psychosocial issues through conception. Oncology 1998; 12: 759-765.

  36. Gemignani ML, Petrek JA. Pregnancy after breast Cancer. Cancer Control 1996; 6: 272-276.

  37. Kroman N, Jensen MB, Melby M et al. Should women be advised against pregnancy after breast cancer treatment? Lancet 1997: 350: 319-322.

  38. Surbone A, Petrek JA. Childbearing issues in breast carcinoma survivors. Cancer 1997; 79: 1271-1278.

  39. Opsahl MS, Fugger E, Sherins RJ, Schulman JD. Conservación de la función reproductiva antes del tratamiento del cáncer. Nuevas opciones que incluyen criopreservación de esperma y ovario. Cancer J 1997; 1: 305-308.

  40. Masala A, Faedda R, Alagna S. Use of testosterone to prevent cyclophosphamide-induced azoospermia. Ann Intern Med 1997; 126: 292-295.

  41. Johnson FE, Liebscher GJ, Tolman KC, Janney CG. Testicular circulatory isolation: not a cause of immune-mediated testis injury in the rat. Ann Surg Oncol 1996; 3: 400-405.

  42. Brewer M, Gershenson DM et al. Outcome and reproductive function after chemotherapy for ovarian dysgerminoma. J Clin Oncol 1999; 17: 2670-2675.

  43. Reynolds T. Cell death genes may hold clues to preserving fertility after chemotherapy. J Nat Cancer Institute 1999; 91: 664-666.




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