Acute subjective morbidity after cisplatin-based combination chemotherapy in patients with testicular cancer: a prospective study.
In a randomized trial, 22 patients with metastatic testicular cancer used low-fibre diet during and after their first cycle of cisplatin and vinblastine containing combination chemotherapy, in order to reduce the acute gastrointestinal post-treatment morbidity (Group 1). Their subjective morbidity, including aspects of general well-being, was compared to 23 comparable patients having no diet restrictions (Group 2). A third similarly composed group consisted of 10 testicular cancer patients without diet restrictions, who received etoposide (VP-16) instead of vinblastine. Low-fibre diet did not reduce the frequency or severity of the acute post-treatment gastrointestinal morbidity. Severe constipation and/or paralytic ileus was observed in 23 patients in Groups 1 and 2 and necessitated short-term hospitalization in 14. The substitution of vinblastine by etoposide resulted in a significant reduction of the acute gastrointestinal morbidity and in a considerable improvement of the patients' general well-being. It is concluded that VP-16 should be given instead of vinblastine to patients receiving cisplatin-based combination chemotherapy in order to maintain an optimal quality of life during cytostatic treatment. This study also indicates that the frequency and severity of subjective treatment-related morbidity often is underestimated by retrospective routine clinical assessment, and should preferably be assessed prospectively by frequently applied patients' questionnaires.
Aass
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Department of Medical Oncology and Radiotherapy, Norwegian Radium Hospital, Montebello, Oslo, Norway.
Fosså
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SD
Otto
F
F
Ose
T
T
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D004043:Dietary Fiber / Q000008:administration & dosage*; D005047:Etoposide / Q000008:administration & dosage; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000517:prevention & control; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011897:Random Allocation; D013736:Testicular Neoplasms / Q000188:drug therapy*; D014747:Vinblastine / Q000008:administration & dosage
D004043:Dietary Fiber; D001761:Bleomycin; D014747:Vinblastine; D005047:Etoposide; D002945:Cisplatin