In this study, long-term survivors of germ-cell tumors have reported cognitive impairment after curative treatment with radiotherapy and chemotherapy compared with controls who had treatment with orchiectomy only. These data provide an argument against the use of adjuvant radiotherapy for stage I seminoma. Unnecessary overtreatment with chemotherapy and additional radiotherapy after chemotherapy should be avoided.

549 Background: Treatment for germ-cell tumors (GCT) may lead to long-term consequences in GCT survivors. This study aimed to evaluate a long-term sexual functioning after curative treatment for GCT. Methods: GCT survivors (N = 155) from a national cancer centre completed a Sexual Function Questionnaire that was modified from PROMIS Sexual Function and Satisfaction Questionnaire at a median 10 years of follow up (range 5-32) as a primary exploratory aim. Seventeen survivors (11%) had orchiectomy alone (controls), while 138 (89%) survivors received treatment beyond orchiectomy. The study group consisted of survivors receiving a cisplatin-based chemotherapy, radiotherapy to the retroperitoneal lymph nodes or both, while the control group included survivors treated with orchiectomy only. Results: Survivors treated with both chemotherapy and radiotherapy or any treatment had difficulty maintaining erection during the intercourse compared to the controls (both P = 0.04). Moreover, patients who received chemotherapy and radiotherapy reported difficulty in achieving orgasm during the intercourse ( P = 0.04) and they were disappointed with their overall quality of sex life ( P = 0.002). No difference in education, employment, marital status and parity was observed between the study groups (all P > 0.05). GCT survivors reported no differences in their sexual desire and in the number of attempts to initiate sexual intercourse in the last month. Survivors from all treatment groups reported none or mild anxiety resulting from sexual relationships and the desire to be sexually active was moderate among all subgroups, with no significant difference. Conclusions: Our prospective study shows that an impairment insexual function is a significant issue for long-term GCT survivors. Treatment with chemotherapy plus radiotherapy had the highest impact on the quality of sex life.

A growing number of targeted anticancer agents has shown the unexpected ability to induce QT interval prolongation. In addition, standard chemotherapeutics and a variety of conditions such as electrolyte abnormalities, endocrine disorders, cardiac diseases, nutritional disturbances and other factors may be associated with long QT syndrome in cancer patients. Prolongation of the QT interval can lead to life-threatening ventricular arrhythmias, including 'torsade de pointes' (TdP). The association between long QT interval and ventricular arrhythmias remains the subject of many controversies. The QT interval represents the time interval of both ventricular depolarization and repolarization. Not only abnormalities of ion channels, but also changes in the myocardial microarchitecture and other factors and disorders frequently seen in cancer patients may participate in its prolongation and potential risk of ventricular arrhythmias. The aim of this review was to summarize current knowledge about QT prolongation in cancer patients with the special focus on targeted therapy.

e21607 Background: Testicular cancer (GCT) survivors are at risk for different types of late treatment sequelae. This study aimed to evaluate long-term quality of life (QOL), sexual (SexF) and cognitive functioning (CogF) issues resulting from cisplatin-based chemotherapy. Methods: QoL, SexF and CogF data were prospectively collected in 83 GCT survivors with median 9 year follow-up (range 5-32). The chemotherapy group (CTG) consisted of 53 and 18 patients receiving a cisplatin cumulative dose of ≤ 400mg/m2 (LCD) and > 400mg/m2 (HCD), respectively. The control group (CG) included 12 patients treated with orchiectomy (6 pts) and adjuvant radiotherapy (6 pts). Data were collected using EORTC QLQ-C30, QLQ-TC26, FACT-Cog and sexual functioning questionnaires and analyzed according to the scoring guidelines. Results:The CTG survivors had significantly (all p < 0.05) more limitations while working or doing daily activities (37% vs 8%), needed to rest more often (61% vs 33%) and feared the disease relapse more often (73% vs 50%) compared to the CG. A subscale for family problems within QLQ-TC26 have shown higher impairment in the CTG vs. CG (mean score ± SEM: 54.2 ± 26.7 vs. 38.8. ± 7.3, P < 0.05). Cognitive abilities were perceived better in CG vs. CTG (mean score 24.5 ± 1.8 vs. 20.5 ± 0.7, P < 0.05). The CG surivors had higher education level and fathered more children compared to the CTG. The CTG felt more unsettled than the CG (all P < 0.05), however the impact of perceived cognitive impairment on their lives did not significantly differ ( P = 0.4). Patients who received HCD have suffered from dyspnea more often than patients treated with LCD (mean dyspnea subscale score ± SEM: 22.2 ± 4.4 vs 8.9 ± 2.6, P < 0.05). The HCD group also reported more difficulties to concentrate while watching television/reading newspaper and struggled to name things during conversation compared with the LCD group ( P < 0.05 for both). No impairment in sexual functioning was reported. Conclusions: Our study shows thatGCT survivors cured with cisplatin-based chemotherapy suffered from QoL issues and their perception of cognitive abilities was altered. The HCD of cisplatin further impaired several QoL and cognitive aspects.