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CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(11): 759-768
DOI: 10.1055/s-0040-1713911
Review Article

Cytotoxic Activity of Antineoplastic Agents on Fertility: A Systematic Review

Atividade citotóxica dos tratamentos antineoplásicos na fertilidade: Uma revisão sistemática
Gabriel Acácio de Moura 
1   Universidade Estadual do Ceará, Fortaleza, CE, Brazil
,
Paula Bruno Monteiro 
2   Centro Universitário Christus Unichristus, Fortaleza, CE, Brazil
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Abstract

Objective To analyze the long-term effects of antineoplastic treatments on patient fertility.

Selection of Studies The studies were selected through the New PubMed, Scielo and Lilacs databases along with references used for the creation of the present work. For the selection of studies, articles published between the periods from January 1, 2015 to April 6, 2020 in the English, Portuguese and Spanish languages were used. As inclusion criteria: cohort studies and studies conducted in vitro. As exclusion criteria: review articles, reported cases, studies that do not address thematic reproduction, studies that do not address the cancer theme, articles that used animals, articles that address the preservation of fertility and articles in duplicate in the bases.

Data Collection The collected data included: age of the patient at the beginning of treatment, type of neoplasm, type of antineoplastic treatment, chemotherapy used, radiotherapy dosage, radiotherapy site, effect of antineoplastic agents on fertility and number of patients in the study.

Data Synthesis Thirty studies were evaluated, antineoplastic chemotherapy agents and radiotherapy modulate serum hormone levels, reduces germ cell quantities and correlated with an increase in sterility rates. The effects mentioned occur in patients in the prepubertal and postpubertal age.

Conclusion Antineoplastic treatments have cytotoxic effects on the germ cells leading to hormonal modulation, and pubertal status does not interfere with the cytotoxic action of therapies.

Resumo

Objetivo Analisar os efeitos a longo prazo dos tratamentos antineoplásicos na fertilidade de pacientes.

Fontes de dados Os estudos foram selecionados através das bases de dados New PubMed, Scielo e Lilacs, junto com as referências utilizadas para a confecção do trabalho.

Seleção dos estudos Para a seleção dos estudos, foram utilizados artigos publicados entre os períodos de 01 de janeiro de 2015 a 06 de abril de 2020 nos idiomas inglês, português e espanhol. Como critérios de inclusão: estudos de coorte e estudos realizados in vitro. Como critérios de exclusão: artigos de revisão, relatos de caso, estudos que não abordavam a temática reprodução, estudos que não abordavam a temática câncer, artigos utilizando animais, artigos que abordavam preservação da fertilidade e artigos em duplicidade nas bases.

Coleta de dados Os dados coletados incluíram: idade do paciente ao início do tratamento, tipo de neoplasia, tipo de tratamento antineoplásico, quimioterápicos utilizados, dosagem da radioterapia, local da radioterapia, efeito dos agentes antineoplásicos na fertilidade e número de pacientes dentro do estudo.

Síntese de dados Trinta estudos foram avaliados. Os agentes quimioterápicos antineoplásicos e a radioterapia modulam níveis séricos hormonais de marcadores de fertilidade, reduzem a quantidade de células germinativas e estão correlacionados com um aumento da taxa de esterilidade. Os efeitos citados anteriormente ocorreram em pacientes com idade pré-púbere e pós-púbere.

Conclusão Os tratamentos antineoplásicos possuem efeitos citotóxicos em células germinativas, levando a modulação hormonal, e o status puberal não interfere diretamente na ação citotóxica das terapias.

Keywords

oncofertility - chemotherapy - radiotherapy - neoplasm - germ tissue

Palavras-chave

oncofertilidade - quimioterapia - radioterapia - neoplasia - tecidos germinativos


Publication History

Received: 28 November 2019

Accepted: 21 May 2020

Article published online:
30 November 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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