Cisplatin neurotoxicity in the treatment of metastatic germ cell tumour: time course and prognosis.
In order to ascertain the incidence and prognosis of cisplatin-induced neurotoxicity in testis cancer patients undergoing combination chemotherapy, 29 patients with metastatic disease were studied prospectively. Assessments included enquiry into neurological symptoms, measurement of sural nerve sensory action potential and conduction velocity, and vibration threshold in the left big toe. At the end of chemotherapy (3 to 4 cycles) only 3 out of 26 (11%) patients had paraesthesiae, but 3 months later the proportion rose to 65%. Resolution occurred in the majority over the ensuing 12 months so that only 17% had persistent symptoms. None of the 11 patients treated with 3 cycles of chemotherapy had persisting symptoms. Vibration thresholds showed a significant deterioration during chemotherapy (P = 0.032), further deterioration in the 3 months following chemotherapy (P = 0.009) and significant improvement between 3 and 12 months after chemotherapy (P = 0.038). Sural nerve sensory action potentials and conduction velocities were unhelpful.
von Schlippe
M
M
Department of Oncology, University College, London, WIN 8AA, UK.
Fowler
C J
CJ
Harland
S J
SJ
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects*; D001927:Brain Diseases / Q000139:chemically induced*; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D005500:Follow-Up Studies; D018237:Germinoma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects; D010292:Paresthesia / Q000139:chemically induced; D011379:Prognosis; D011446:Prospective Studies; D011930:Reaction Time / Q000187:drug effects*; D013497:Sural Nerve / Q000187:drug effects; D013736:Testicular Neoplasms / Q000188:drug therapy*
D000970:Antineoplastic Agents; D002945:Cisplatin