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Cisplatin-based chemotherapy linked to severe side effects in long-term survivors of testicular cancer
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Long-term survivors of unilateral testicular cancer treated with cisplatin-based chemotherapy had more dose-dependent neurological side effects and Raynaud-like phenomena, or discoloration of the fingers and toes upon exposure to cold, when compared with patients who were not treated with chemotherapy, according to the results of a follow-up study.
The study examined 1,814 men from Norway who were treated for testicular cancer from 1980 to 1994; 1,409 men responded to a questionnaire for a national, multicenter survey. Researchers assessed the occurrence of self-reported paresthesias, Raynaud-like phenomena, tinnitus and impaired hearing. Median follow-up was 10.7 years.
Respondents who had received chemotherapy were classified into three groups based on cisplatin administration: up to four cycles, five or more cycles, or dose-intensive chemotherapy.
When compared with those not treated with chemotherapy, men treated with chemotherapy had elevated odds for increasing severity of all symptoms and inferior audiometric results, with the exception of the group treated with more than five cycles.
The most frequent symptoms were Raynaud-like phenomena in the hands or feet (39%). Paresthesias was reported by 29% of patients; 21% reported hearing impairment and 22% reported tinnitus.
In the dose-intensive chemotherapy group, hearing impairment (OR=5.3; 95% CI, 3.0-9.2) and tinnitus (OR=7.1; 95% CI, 4.1-12.4) were particularly common compared with men who were not treated with chemotherapy.
“A major aim in the treatment of testicular cancer is to minimize toxic effects without compromising the high cure rate,” researchers said. “Our data favor the use of chemotherapy regimens that contain 20 mg/m2 cisplatin per day to limit ototoxicity.”
Brydøy M. J Natl Cancer Inst. 2009;101:doi:10.1093/jnci/djp413/.
