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J Oncol Pharm Pract. 2013 Dec;19(4):321-7. doi: 10.1177/1078155212469243. Epub 2013 Jan 4.

Impact of temozolomide on gonadal function in patients with primary malignant brain tumors.

Author information

1
Department of Neurology, Wake Forest School of Medicine, NC, USA.

Abstract

BACKGROUND:

Cumulative exposure to alkylating agents may produce impaired reproductive function. Temozolomide is an alkylating agent approved for treating malignant gliomas.

OBJECTIVE:

A pilot study was undertaken to investigate the effects of temozolomide on semen integrity in men with newly diagnosed or recurrent malignant gliomas.

METHODS:

Eligible patients had no known fertility problems or impotence. Comprehensive semen analysis and serum sex hormones were obtained at baseline and following 3 and at least 6 months of temozolomide.

RESULTS:

Thirteen men were recruited. Mean age was 42 years (28-58). Three had recurrent and 10 newly diagnosed malignant glioma. Four were unable to ejaculate or were azoospermic at baseline. Four provided samples at baseline and after at least 6 months of temozolomide. Five were unable to complete the study. Two of four patients with paired baseline and 6-month samples received 6 months of standard monthly temozolomide. Two patients received standard radiation and concurrent temozolomide followed by adjuvant temozolomide. At 6 months, three of these four patients demonstrated low sperm motility (two low at baseline); three had abnormally low percent normal forms (one abnormal at baseline); two developed abnormally low sperm density. Sex hormone values were normal in all four patients at all time points.

CONCLUSION:

Changes in semen analysis parameters following 6 months of temozolomide were observed. The small sample size precludes any firm conclusions regarding the importance and duration of these findings and their relation to temozolomide exposure. With validation in a larger study, these results may have important implications for counseling prior to initiation of temozolomide therapy in these patients.

KEYWORDS:

Malignant glioma; fertility; temozolomide

PMID:
23292971
PMCID:
PMC3873838
DOI:
10.1177/1078155212469243
[Indexed for MEDLINE]
Free PMC Article

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