Long-term sequelae of treatment for testicular germ cell tumours.
Seventy-four patients previously treated in our department for germ cell tumour of the testis underwent a series of tests to determine the frequency of long-term therapeutic complications. All had received cisplatin-based chemotherapy as part of their treatment. There was a significant deterioration in renal function throughout the group. Eighteen (24%) had supine blood pressure greater than systolic 140 mmHg or diastolic 90 mmHg after treatment but hypertension did not correlate with renal impairment. Raynaud's phenomenon was common after chemotherapy (26/74) as was persistent sensory neuropathy (23/74). Although 34% had testosterone levels below the normal range, only six patients had a low free testosterone index with one testis still in situ; 18 patients have fathered children after chemotherapy. Approximately half of the patients completed a psychosexual questionnaire and some 30% of them admitted to sexual problems which they attributed to their treatment. Long-term sequelae of cisplatin-based chemotherapy for testicular malignancy are frequent and persistent, and follow-up of these patients should include prospective measurement of changes in blood pressure.
Bissett
D
D
CRC Department of Medical Oncology, Beatson Oncology Centre, Western Infirmary, Glasgow, UK.
Kunkeler
L
L
Zwanenburg
L
L
Paul
J
J
Gray
C
C
Swan
I R
IR
Kerr
D J
DJ
Kaye
S B
SB
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000097:blood; D006311:Hearing Disorders / Q000139:chemically induced; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000523:psychology; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D011928:Raynaud Disease / Q000139:chemically induced; D012725:Sexual Behavior; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000523:psychology
D000970:Antineoplastic Agents; D012739:Gonadal Steroid Hormones