Testicular function of survivors of childhood cancer: A comparative study between ifosfamide- and cyclophosphamide-based regimens 5 Vita Ridola a,b , Oumaya Fawaz a , Franc ¸oise Aubier c , Christophe Bergeron d , Florent de Vathaire e , Fabienne Pichon f , Daniel Orbach g , Jean Claude Gentet h , Claudine Schmitt i , Christelle Dufour a , Odile Oberlin a, * a Department of Pediatric and Adolescent Oncology, Institut Gustave Roussy, Villejuif, France b Department of Pediatric Oncology, Catholic University of Rome, Italy c Department of Oncology, Centre The ´rapeutique, Margency, France d Department of Pediatric Oncology, Centre Leon Be ´rard, Lyon, France e INSERM U605, Villejuif, France f Department of Pediatric, Centre Oscar Lambret, Lille, France g Department of Pediatric Oncology, Institut Curie, Paris, France h Department of Pediatric Oncology, University Hospital La Timone, Marseille, France i Department of Oncology and Hematology, University Hospital, Nancy, France ARTICLE INFO Article history: Received 6 August 2008 Received in revised form 15 December 2008 Accepted 9 January 2009 Available online 11 February 2009 Keywords: Ifosfamide Cyclophosphamide Fertility Male Toxicity Gonads Long-term sequelae ABSTRACT Purpose: This study aimed at comparing gonadal toxicity of ifosfamide versus cyclophos- phamide received during childhood. Methods: The evaluation was based on basal FSH measurement. LH and testosterone were also measured in most of the patients. One hundred patients had received ifosfamide and 59 had received cyclophosphamide. Results: Median age at treatment was 11.2 years. The median interval since treatment was 10.7 years (range 4.1–20.2) and median age at evaluation was 21.4 years (17.5–36.1). The median dose of ifosfamide and of cyclophosphamide was 54 g/m 2 (18–114) and 8.3 g/m 2 (4.6–22), respectively. All but two males had normal testosterone levels. FSH was abnormal in 28/59 patients (47.5%) after receiving cyclophosphamide and was within the normal range in 94/100 patients (94%) after receiving ifosfamide. Conclusions: These results show that ifosfamide is associated with a lower risk of gonadal damage than cyclophosphamide. The risk of abnormal FSH increased with the cumulative dose of cyclophosphamide. Ó 2009 Elsevier Ltd. All rights reserved. 0959-8049/$ - see front matter Ó 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.ejca.2009.01.002 5 This study was previously orally presented at: (1) Sarcoma Meeting Stuttgart, Germany, 2005; (2) Congress of the International Society of Paediatric Oncology, Vancouver, Canada, 21–24 September 2005; (3) American Society of Clinical Oncology, Chicago, 2007. * Corresponding author: Tel.: +33 1 42114174; fax: +33 1 42115275. E-mail address: oberlin@igr.fr (O. Oberlin). EUROPEAN JOURNAL OF CANCER 45 (2009) 814 – 818 available at www.sciencedirect.com journal homepage: www.ejconline.com