The occurrence of colorectal cancer in individuals with potentially reproductive age has increased. Oxaliplatin is a cornerstone treatment in the adjuvant setting for stage III and high-risk stage II colorectal cancer in patients up to 70 years of age. The aim of this study was to investigate sex hormones and sperm function after oxaliplatin-based chemotherapy to clarify the risk for hypogonadism and infertility.
Through 2006-2013 20 males (aged ≤55 and younger) and 16 females (aged ≤40 and younger) were included. All had undergone radical surgery due to colorectal cancer, and were planned for adjuvant oxaliplatin in combination with 5-fluorouracil. Measurement of LH, FSH, testosterone, SHBG and sperm analysis was done in males. LH, FSH and estradiol was measured in females. Measurements were done after surgery, after cessation of adjuvant cytostatic treatment and at follow-up 1-5 years after end of treatment.
FSH and testosterone levels increased in males, but were restored at follow-up. No patients went from normal gonadal function to hypogonadism. There was a tendency towards a decrease in sperm concentration, (p = 0.,063). When comparing sperm concentration and rapid progressive motility before treatment and at follow-up, there was no differences, and we observed no patients that turned overtly infertile by treatment. No distinct altering of gonadal function could be observed in the females.
From the results of this study, oxaliplatin seems to incur transient decrease in sperm concentration with recovery, and some but not pronounced increase in FSH in males. The risk for infertility and hypogonadism in males and females after adjuvant oxaliplatin-based chemotherapy seems to be low to moderate, but the general recommendation of appropriate fertility conserving measures shall should not be changed.
The authors.
Has not received any funding.
P. Österlund: Honoraria (self): Amgen; Honoraria (self): Bayer; Honoraria (self): Celgene; Honoraria (self): Eli Lilly; Honoraria (self): Merck; Honoraria (self): Nordic Drugs; Honoraria (self): Roche; Honoraria (self): Sanofi; Honoraria (self): Servier; Travel / Accommodation / Expenses: Pierre Fabre; Travel / Accommodation / Expenses: AstraZeneca; Travel / Accommodation / Expenses: AbbVie. E. Hofsli: Honoraria (self): Amgen. H. Sorbye: Honoraria (self): Novartis; Honoraria (self): Ipsen; Honoraria (self): Pfizer; Honoraria (self): Keocyt; Honoraria (self): AstraZeneca; Honoraria (self): Roche; Honoraria (self): Amgen; Honoraria (self): Merck; Honoraria (self): Shire; Honoraria (self): Celgene; Honoraria (self): Nordic Drugs. All other authors have declared no conflicts of interest.