Recovery of spermatogenesis after treatment for Hodgkin's disease: limiting dose of MOPP chemotherapy.

The sperm production of 25 patients with Hodgkin's disease treated with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy was studied retrospectively. All but two patients also received radiotherapy treatment to pelvic and/or non-pelvic fields. Sperm counts were obtained from patients treated either with three or fewer (MOPP-2 group) or with five or more (MOPP-6 group) chemotherapy cycles. Recovery of spermatogenesis following treatment-induced azoospermia was significantly higher among the MOPP-2 patients (Mann-Whitney rank sum test, p = 0.001). Patients in this group who did not receive pelvic irradiation appeared to have greater recovery rates (p = 0.06). The results suggest that three cycles of MOPP chemotherapy represent a maximum exposure compatible with the recovery of spermatogenesis.

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Rapid recovery of spermatogenesis after mitoxantrone, vincristine, vinblastine, and prednisone chemotherapy for Hodgkin's disease.

Journal of Clinical Oncology ◽

10.1200/jco.1997.15.12.3488 ◽

1997 ◽

Vol 15 (12) ◽

pp. 3488-3495 ◽

Cited By ~ 50

Author(s):

M L Meistrich ◽

G Wilson ◽

K Mathur ◽

L M Fuller ◽

M A Rodriguez ◽

...

Keyword(s):

Hodgkin's Disease ◽

Male Fertility ◽

Sperm Count ◽

Hodgkin’S Disease ◽

Spermatogenic Cells ◽

Sperm Production ◽

Human Male ◽

Sperm Counts ◽

Abdominal Radiotherapy ◽

Upper Abdominal

PURPOSE Because the effects of mitoxantrone on human male fertility were unknown, we determined prospectively the effects of three courses of mitoxantrone (Novantrone), vincristine (Oncovin), vinblastine, prednisone (NOVP) chemotherapy on the potential for fertility of men with Hodgkin's disease (HD). PATIENTS AND METHODS Semen analyses were performed on 58 patients with stages I-III HD before, during, and after chemotherapy and after the sperm count recovered from the effects of abdominal radiotherapy that was given after chemotherapy. RESULTS Before the initiation of treatment, 84% of the patients were normospermic. Sperm counts declined significantly within 1 month after the start of NOVP chemotherapy. In the month after chemotherapy, 38% of patients were azoospermic, 52% had counts < 1 million/ mL, and 10% had counts between 1 and 3 million/mL. Between 2.6 and 4.5 months after the completion of chemotherapy, sperm counts recovered rapidly to normospermic levels in 63% of patients. In the remaining patients who were followed up for at least 1 year after standard upper abdominal radiotherapy, counts also recovered to normospermic levels. CONCLUSION NOVP chemotherapy, like most other regimens, produced marked temporary effects or spermatogenesis. However, sperm production recovered very rapidly, within 3 to 4 months after the end of NOVP chemotherapy. This pattern was caused by killing differentiating spermatogenic cells, but there was little cytotoxicity or inhibition of stem cells from mitoxantrone or the other drugs. After the combination of NOVP plus abdominal radiotherapy, sperm counts and motility were restored in most patients to pretreatment levels, which were compatible with normal fertility.

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Are pelvic irradiation and routine staging laparotomy necessary in clinically staged IA and IIA Hodgkin's disease?

Cancer ◽

10.1002/1097-0142(197712)40:6<2914::aid-cncr2820400623>3.0.co;2-u ◽

1977 ◽

Vol 40 (6) ◽

pp. 2914-2916 ◽

Cited By ~ 22

Author(s):

Thomas Griffin ◽

Arthur Gerdes ◽

Robert Parker ◽

Eric Taylor ◽

Mark Hafermann ◽

...

Keyword(s):

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Pelvic Irradiation ◽

Staging Laparotomy

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The impact of pelvic recurrence and elective pelvic irradiation on survival and treatment morbidity in early-stage Hodgkin's disease

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/0360-3016(90)90727-2 ◽

1990 ◽

Vol 19 ◽

pp. 163-164

Author(s):

Nancy P. Mendenhall ◽

Bernard S. Taylor ◽

Robert B. Marcus ◽

Rodney R. Million

Keyword(s):

Hodgkin's Disease ◽

Early Stage ◽

Hodgkin’S Disease ◽

Pelvic Recurrence ◽

Pelvic Irradiation ◽

Treatment Morbidity ◽

The Impact

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Assessing short-term effects and costs at an early stage of innovation: The use of positron emission tomography on radiotherapy treatment decision making

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646230808029x ◽

2008 ◽

Vol 24 (02) ◽

pp. 212-220 ◽

Cited By ~ 13

Author(s):

Raphaël Remonnay ◽

Magali Morelle ◽

Pascal Pommier ◽

Francesco Giammarile ◽

Marie-Odile Carrère

Keyword(s):

Lung Cancer ◽

Decision Making ◽

Positron Emission Tomography ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Emission Tomography ◽

Positron Emission ◽

The Mean ◽

Mean Cost ◽

Radiotherapy Treatment

Objectives:Positron emission tomography (PET) is an innovative imaging tool. Associated with computed tomography (CT), it allows a better definition for the tumor volume for radiotherapy, compared with CT only. The aim of this study was to assess the effects of PET on resource allocation (costs and savings) and on the choice of the following treatment in radiotherapy.Methods:In 2004 and 2005, 209 patients were enrolled (97 patients with Hodgkin's disease and 112 with non-small cell lung cancer) in a national study conducted in eight hospitals. Two treatment decisions made on the basis of CT only or CT associated with PET, were compared in a prospective study where each subject was his/her own control. The direct medical cost of using PET was assessed by microcosting, using data collected from specific questionnaires. The costs of new tests and the costs and savings associated with changes in the chosen treatment were calculated on the basis of reimbursement rates.Results:The mean cost of using PET was approximately €800 per patient (50 percent for the radionuclide18F-FDG [2-[18F]fluoro-2-deoxy-D-glucose]). Radiotherapy treatments were modified for 10 percent of patients with Hodgkin's disease versus 40 percent of patients with lung cancer. Overall, the use of PET induced both increases and decreases in the mean cost per patient: the net effect was a €425 and €931 cost increase in lung cancer and Hodgkin's disease, respectively.Conclusions:The use of PET for radiotherapy decision making seems more valuable for lung cancer than for Hodgkin's disease, both in terms of costs and changes in radiotherapy treatment. This result might help policy makers for prioritization.

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