Clinical and biochemical long-term toxicity after postoperative cisplatin-based chemotherapy in patients with low-stage testicular cancer.
In this case-control study the long-term chemotherapy-related morbidity was assessed in testicular cancer patients (> or = 5 years after treatment). The case group consisted of 47 patients with nonseminomatous testicular cancer who had undergone retroperitoneal surgery and 3-4 cycles of conventional-dose cisplatin-based chemotherapy (accumulated cisplatin dose: 300-400 mg/m2), also containing vinblastine and bleomycin. The results of the clinical and biochemical investigations and the patients' responses to a questionnaire were compared to similar observations from a control group comprising 47 patients treated with surgery only. In the case group the serum magnesium values and the levels of FVIIvWF were significantly lower (but within the normal range) than in the control group. Serum cholesterol values were distributed similarly in both groups. About 40% of the patients from the chemotherapy group still suffered from Raynaud-like phenomena and/or sensoric neurotoxicity as compared to 10% of the patients from the control group. Chemotherapy resulted in a significant elevation of serum LH within the normal range, probably associated with a slight subclinical Leydig cell dysfunction. Serum FSH levels were similar in the case and control groups, indicating an absence of long-term disturbance of spermatogenesis after chemotherapy. No increased cardiovascular morbidity was observed as a result of chemotherapy. Raynaud-like phenomena and sensoric neurotoxicity represent the principal clinical long-term side effects after 3-4 cycles of cisplatin-based chemotherapy containing vinblastine and bleomycin. Serum LH is slightly elevated after chemotherapy, whereas long-term spermatogenesis seems to be unaffected.
Fosså
S D
SD
Department of Medical Oncology and Radiotherapy, Norwegian Radium Hospital, Oslo.
Lehne
G
G
Heimdal
K
K
Theodorsen
L
L
D000293:Adolescent; D000328:Adult; D001761:Bleomycin / Q000008:administration & dosage; D016022:Case-Control Studies; D002945:Cisplatin / Q000009:adverse effects*; D003131:Combined Modality Therapy; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011928:Raynaud Disease / Q000209:etiology; D012187:Retroperitoneal Space; D013736:Testicular Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D014747:Vinblastine / Q000008:administration & dosage
D001761:Bleomycin; D014747:Vinblastine; D007986:Luteinizing Hormone; D002945:Cisplatin