尝试用d -色氨酸-6黄体生成素释放激素保护精原细胞瘤患者的精子发生。

W Brennemann, K A Brensing, N Leipner, I Boldt, D Klingmüller
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引用次数: 45

摘要

本文首次探讨了精原细胞瘤患者中d -色氨酸-6黄体生成素释放激素(d -色氨酸-6- lh - rh)对辐照致睾丸损伤的保护作用。在单侧睾丸切除术后,12名男性在放疗前和放疗期间接受长效促性腺激素释放激素(GnRH)激动剂D-Trp-6-LH-RH。8名患有相同疾病的患者作为对照组。与几项保护精子发生免受GnRH激动剂化疗影响的试验相反,我们在开始治疗前首先抑制垂体-睾丸轴。作为一种新的治疗方案,这种辅助GnRH激动剂治疗在前20天与醋酸环丙孕酮联合使用,以减少促性腺激素和睾酮的初始刺激量和持续时间。在抑制垂体-性腺轴后开始照射。在所有患者中,与对照组相比,黄体生成素和睾酮在整个治疗过程中都被完全抑制,而促卵泡激素的初始抑制直到放疗完成才完全维持。在治疗完成后18个月的随访中,所有患者的促性腺激素、睾酮和活动精子的初始浓度均达到独立于D-Trp-6-LH-RH治疗的水平。随着剂量和时间表的研究,GnRH激动剂对放疗引起的睾丸损伤没有保护作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Attempted protection of spermatogenesis from irradiation in patients with seminoma by D-Tryptophan-6 luteinizing hormone releasing hormone.

Possible protective effects of D-Tryptophan-6 luteinizing hormone releasing hormone (D-Trp-6-LH-RH) against irradiation-induced testicular damage were investigated for the first time in patients with seminoma. After unilateral orchiectomy 12 men were allocated to receive the long-acting gonadotropin releasing hormone (GnRH) agonist D-Trp-6-LH-RH prior to and for the duration of radiotherapy. Eight patients with the same disease served as a control group. In contrast to several trials to protect spermatogenesis from chemotherapy by GnRH agonists, we first suppressed the pituitary-testicular axis before starting the treatment. As a new schedule this adjuvant GnRH agonist treatment was combined with cyproterone acetate for the first 20 days to diminish the amount and the duration of the initial stimulation of gonadotropins and testosterone. Irradiation started after suppression of the pituitary-gonadal axis. In all patients luteinizing hormone and testosterone were completely suppressed throughout the treatment compared to the controls, whereas the initial suppression of follicle-stimulating hormone was not completely maintained until radiotherapy was completed. At the follow-up at 18 months after completion of therapy, all patients reached their initial concentration of gonadotropins, testosterone, and motile spermatozoa independently of D-Trp-6-LH-RH treatment. With the dose and schedule investigated, the GnRH agonist showed no protective effects against testicular damage caused by radiotherapy.

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