Evaluation of long-term toxicity in patients after cisplatin-based chemotherapy for non-seminomatous testicular cancer.

Abstract

BACKGROUND:

Because of the increasing number of long-term survivors of metastatic testicular germ-cell cancer, a general concern has been secondary morbidities, especially cardiovascular risk factors.

PATIENTS AND METHODS:

Thirty-two patients treated with cisplatin- and doxorubicin-containing chemotherapy > or = 13 years before the time of analyses were evaluated for neuro-, oto-, pulmonary-, vascular- and gonadal toxicity including evaluation of myocardial damage and cardiovascular risk factors and analysis of microcirculation.

RESULTS:

Thirty percent of the patients showed abnormal left ventricle function. Elevated follicle stimulating hormone (FSH) and luteinising hormone (LH) levels in 75% of patients were often associated with low testosterone levels. Elevated total cholesterol levels were found in 82% and higher triglyceride levels in 44% of patients, most of them were overweight. About 25% of the patients developed diastolic arterial hypertension after chemotherapy. Reduced hearing was confirmed in 23% of patients, especially at frequencies higher than 3000 Hz. Moreover, 53% of patients presented transient evoked otoacoustic emissions. In 38% of patients non-symptomatic neuropathy was detected, in 28% symptomatic neuropathy, and in 6% disabling polyneuropathy. In 80% of patients with neuropathic symptoms additional morphological and functional abnormalities were found by nailfold capillary videomicroscopy, compared to only 57% of the patients without neuropathic symptoms.

CONCLUSIONS:

Patients cured by cisplatin-based chemotherapy for metastatic testicular cancer have to be cognizant of their unfavorable cardiovascular risk profile, that might be a greater risk than developing a relapse or second malignancy.

• Authors: D Strumberg, S Brügge, M W Korn, S Koeppen, J Ranft, G Scheiber, C Reiners, C Möckel, S Seeber, M E Scheulen
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 13 Issue 2 Pg. 229-36 (Feb 2002) ISSN: 0923-7534 [Print] England
• PMID: 11885999 (Publication Type: Journal Article)

Chemical References

• Luteinizing Hormone
• Follicle Stimulating Hormone
• Cisplatin

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Blood Pressure (drug effects)
• Cisplatin (adverse effects)
• Fertility (drug effects)
• Follicle Stimulating Hormone (blood)
• Hearing (drug effects)
• Heart (drug effects)
• Humans
• Luteinizing Hormone (blood)
• Male
• Middle Aged
• Peripheral Nervous System Diseases (chemically induced)
• Testicular Neoplasms (drug therapy)