Effets de la radiothérapie sur la fonction testiculaire de l'adulte View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

1995-12

AUTHORS

J. M. Bachaud, C. Alzieu, L. Bujan

ABSTRACT

En radiothérapie, les faibles doses provenant du rayonnement diffusé sont suffisantes pour léser les organes très radio-sensibles situés à proximité du volume traité tels que les testicules. Les études réalisées en dose unique sur des volontaires ont montré que des doses inférieures à 10 cGy n'entraînent aucune lésion détectable par spermogramme ou biopsie testiculaire. Une oligospermie sévère s'installe à partir de 15 cGy et 90% des patients sont azoospermiques après 100 cGy. En règle, les irradiations thérapeutiques ne sont pas délivrées en dose unique mais selon un protocole fractionné afin d'obtenir un effet différentiel entre tissue sain et tissu tumoral. A dose égale, ces irradiations fractionnées sont à l'origines de lésion germinales testiculaires plus importantes et plus durables que les irradiations en dose unique. Ainsi des doses fractionnées supérieures à 50 cGy entraînent une azoospermie dans 100% des cas. Cette azoospermie n'est que transitoire jusqu' à 200 cGy, la récupération pouvant cependant être incomplète et ne survenir que plusieurs années après l'irradiation. Au-delà de 200 cGy, il existe un risque d'azoospermie définitive. Les spermatogonies sont les cellules les plus radio-sensibles de la lignée. Leur atteinte conditionne l'effet de la radiothérapie sur la fertilité. En pratique courante, l'hypogonadisme clinique est exceptionnel, ce qui prouve la relative radio-résistance des celules de Leydig. Cependant, les études fonctionnelles montrent que les taux sériques de LH s'élèvent lorsque la dose testiculaire augmente, les taux de testostérone restant initialement dans les limites de la normale. More... »

PAGES

476

Journal

TITLE

Andrologia

ISSUE

4

VOLUME

5

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf03034531

DOI

http://dx.doi.org/10.1007/bf03034531

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1044826255


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