Long-term complications of platinum-based chemotherapy in testicular cancer survivors.
The purpose of this study was to describe the rates of cardiovascular and other medical complications related to the use of platinum-based chemotherapy in American testicular cancer survivors. The study sample consisted of 143 eligible long-term testicular cancer survivors. Participants were interviewed, their medical records were reviewed, and blood was obtained for cholesterol measurement during their follow-up visit. The mean follow-up time was 8.4 yr, and their mean age at follow-up was 41.2 yr; 72.7% had had non-seminoma, and 82.5% had received platinum-based chemotherapy. Hypertension rates in the platinum-treated group increased significantly from baseline to follow-up; however, once adjusted for blood pressure measurement (undiagnosed hypertension), no such increase was seen, and hypertension rates were already higher than national estimates at baseline in all groups. At the follow-up visit, the rates of hyperlipidemia (adjusted for measured cholesterol level) in both platinum- and non-platinum-treated groups (28.4% and 37.5%, respectively) were higher than national estimates (16.9%). Rates of coronary artery disease were higher in those who had received platinum and radiation (11.1%) than in those who had received platinum alone (4.3%), but this difference was not statistically significant. As suggested by previous studies, platinum-based chemotherapy may be associated with hypertension, hyperlipidemia, and coronary artery disease. However, our data suggest that undiagnosed hypertension and hyperlipidemia may be significant confounders, and we also observed a trend toward lower testosterone levels in participants who experienced cardiovascular complications.
Oh
J H
JH
Department of General Internal Medicine, Ambulatory Treatment and Emergency Care, Unit 437, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030-4009, USA. jhoh@mdanderson.org
Baum
D D
DD
Pham
S
S
Cox
M
M
Nguyen
S T
ST
Ensor
J
J
Chen
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000139:chemically induced; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000139:chemically induced*; D006973:Hypertension / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000139:chemically induced; D012307:Risk Factors; D017741:Survivors; D013736:Testicular Neoplasms / Q000097:blood / Q000188:drug therapy*; D013739:Testosterone / Q000097:blood
D000970:Antineoplastic Agents; D013739:Testosterone; D002945:Cisplatin