Endocrinological late effects after chemotherapy for testicular cancer

Berger, C; Bokemeyer, Carsten; Schuppert, Frank; Schmoll, H.-J.

doi:10.1038/bjc.1996.213

Cited by 58 publications

(22 citation statements)

References 41 publications

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“…In a subset of survivors of testicular cancer who had undergone cisplatin-based chemotherapy in an earlier study, 63% had elevated serum levels of follicle-stimulating hormone, 24% had elevated levels of luteinizing hormone. [130].…”

Section: Gonadal Dysfunctionmentioning

confidence: 95%

Endocrine sequelae of cancer and cancer treatments

2007

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Section: Gonadal Dysfunctionmentioning

confidence: 95%

Endocrine sequelae of cancer and cancer treatments

2007

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“…Any hormonal or metabolic changes leading to posttreatment BMI increase may be more pronounced shortly after chemotherapy than later on in life (Gietema et al, 1992;Berger et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

Excessive annual BMI increase after chemotherapy among young survivors of testicular cancer

2003

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Increased body mass index (BMI) is claimed to be a complication among survivors of testicular cancer (TCSs), especially after receiving cisplatin-based chemotherapy. This study compares changes in BMI (kg m À2 ) in TCSs with those observed in age-matched men from the population (controls). Associations between treatment, age and potential BMI changes were sought. In 1999, a survey was performed at the NRH of 444 unilaterally orchiectomised TCSs treated from 1980 to 1990. BMI at survey was recorded in each TCS. Information on principal treatment (surgery only: SURG; radiotherapy only: RAD; chemotherapy 7 surgery or radiotherapy: CHEM7) and pretreatment BMI was retrieved from the medical records. The age-matched controls had BMI measurements from population surveys from 1985 and 1996. The annual BMI increase was calculated based on the difference in the two BMI measurements divided by observation time. TCSs displayed a lower pretreatment mean BMI than the controls, whereas no difference was found post-treatment. However, the annual BMI increase in TCSs exceeded that of the controls (0.19 vs 0.15, P ¼ 1.4 Â 10 À7 ). The SURG and CHEM7 groups showed the greatest annual BMI increase. The multiple regression analysis showed that young TC patients who received chemotherapy displayed an excessive annual BMI increase. Oncologists and young TCSs should be aware of the risk of excessive BMI increase, in particular, after the use of chemotherapy.

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“…However, supportive measures during therapy such as electrolyte substitution, the use of corticosteroids for antiemesis and the use of diuretics had no significant influence. Another important finding was the detection of hormonal imbalances, particularly influencing steroid hormone syntheses and cholesterol levels, in approximately one third of patients [67,68]. The detection of all long-term alterations in body function is essential, and further toxicity studies are necessary.…”

Section: The Impact Of Therapy-associated Toxicity On Treatment Stratmentioning

confidence: 99%

“…During a recent investigation of ours, the extent and the reversibility of these late effects after chemotherapy in long-term survivors of testicular cancer were evaluated. In particular, the influence of therapy and patient characteristics on the occurrence of late toxicity and on the relationship between different toxicities was assessed [8,64,67]. The incidences of transient and irreversible long-term toxicities after chemotherapy are given in table 7.…”

Section: The Impact Of Therapy-associated Toxicity On Treatment Stratmentioning

confidence: 99%

“…Currently, at least 3 different strategies are being investigated ( Values are percentages. Results from 90 patients at Hannover University Medical School [8,64,67]. Ototoxicity was assessed by audiometric evaluation, neurotoxicity according to clinical investigation, Raynaud's syndrome was evaluated by light plethysmography and Doppler-ultrasound investigation and gonadal toxicity according to hormone evaluation.…”

Section: New Drugs For Treatment Of Testicular Cancermentioning

confidence: 99%

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Current Trends in Chemotherapy for Metastatic Nonseminomatous Testicular Germ Cell Tumors

Bokemeyer

1998

Oncology

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With the introduction of cisplatin-based chemotherapy, metastatic testicular cancer represents a model for a highly curable malignant disease. Approximately 70–80% of patients achieve a durable remission following chemotherapy ± secondary surgery of residual tumors. With the development of prognostic classifications based on clinically available parameters, the aims of chemotherapy have been twofold: on the one hand, the reduction of toxicity in patients with ‘low-risk’ metastatic disease without a concomitant reduction in treatment efficacy and, on the other hand, the improvement of treatment results in patients with ‘poor-prognosis’ criteria who achieve a long-term cure rate of less than 50% with standard chemotherapy regimens. Despite a number of large randomized studies attempting either to avoid the toxicity of bleomycin or to reduce cisplatin-associated side-effects through the substitution with carboplatin, the combination of cisplatin, etoposide and bleomycin (PEB) given at 3-week intervals still remains the standard treatment for metastatic disease. The role of high-dose chemotherapy with autologous stem cell support is currently being investigated in order to improve the outcome of patients with relapse after previous chemotherapy and of patients initially exhibiting advanced metastatic disease. For patients with relapsed disease receiving high-dose chemotherapy, a prognostic score has recently been developed: cisplatin-refractory disease, beta human gonadotropin values >1,000 U/l or primary mediastinal germ cell tumors are factors characterizing patients which will profit less from high-dose chemotherapy treatment than patients with chemosensitive disease at relapse. Standard dose salvage regimens only result in a 20% long-term survival rate. In contrast, high-dose salvage chemotherapy may yield a cure rate of approximately 40%. However, the only randomized study comparing high-dose versus conventional-dose therapy in patients with relapsed disease is still ongoing. The investigation of dose-intensive approaches as first-line treatment is currently being studied by several institutions. Despite preliminary favorable results, this approach still cannot be considered standard treatment. A randomized study comparing high-dose chemotherapy with 4 cycles of standard PEB was initiated in the USA in 1996. The evaluation of new drugs in testicular cancer patients with absolute cisplatin-refractory disease has demonstrated that paclitaxel is one of the few agents with antitumor activity in these patients. Paclitaxel has therefore been included in combination regimens – such as cisplatin, ifosfamide and paclitaxel – for the treatment of patients with first and second relapse of testicular cancer. These combinations are used as induction therapy prior to high-dose salvage treatment. Due to the large group of patients with metastatic disease being cured nowadays, the long-term side effects of treatment have become even more important. One of the major risk factors for the development of late toxicities such as ot...

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Endocrinological late effects after chemotherapy for testicular cancer

Cited by 58 publications

References 41 publications

Endocrine sequelae of cancer and cancer treatments

Endocrine sequelae of cancer and cancer treatments

Excessive annual BMI increase after chemotherapy among young survivors of testicular cancer

Current Trends in Chemotherapy for Metastatic Nonseminomatous Testicular Germ Cell Tumors

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