Line V Hjelle1,2, Per O M Gundersen3, Ragnhild Hellesnes2, Mette Sprauten4, Marianne Brydøy5, Torgrim Tandstad6, Tom Wilsgaard7, Sophie D Fosså4,8,9, Jan Oldenburg8,10, Roy M Bremnes1,2, Hege S Haugnes1,2. 1. a Department of Clinical Medicine , Arctic University of Tromsø , Norway. 2. b Department of Oncology , University Hospital of North Norway , Tromsø , Norway. 3. c Department of Clinical Pharmacology , St. Olav's University Hospital , Trondheim , Norway. 4. d Department of Oncology , Oslo University Hospital the Norwegian Radium Hospital , Oslo , Norway. 5. e Department of Oncology and Medical Physics , Haukeland University Hospital , Bergen , Norway. 6. f The cancer Clinic, St. Olav's University Hospital , Trondheim , Norway. 7. g Department of Community Medicine , Arctic University of Tromsø , Tromsø , Norway. 8. h Medical Faculty , University of Oslo , Norway. 9. i Cancer Registry of Norway , Oslo , Norway. 10. j Department of Oncology , Akershus University Hospital , Oslo , Norway.
Abstract
BACKGROUND: The long-term toxicities after cisplatin-based chemotherapy (CBCT) reveal a remarkable inter-individual variation among testicular cancer survivors (TCSs). Therefore, we assessed long-term platinum (Pt) changes and their associations with CBCT-related late effects in TCSs. MATERIAL AND METHODS: In 77 TCSs treated with CBCT from 1984 to 1990, blood samples for analyses of Pt and a questionnaire including self-reported neuro- and ototoxicity (NTX) symptoms were collected during two follow-up surveys at median 12 (Survey I; SI) and 20 (Survey II; SII) years after treatment. Information about second cancers after SII was retrieved from the Norwegian Cancer Registry. RESULTS: A larger Pt decline from SI to SII was associated with a decreased risk of a second cancer diagnosis (HR 0.78, 95% CI 0.62-0.99 per 10 ng/L/year), and worsening of paresthesias in hands (OR 1.98, 95% CI 1.09-3.59 per 10 ng/L/year) and tinnitus (OR 1.51, 95% CI 1.01-2.27 per 10 ng/L/year). CONCLUSION: In summary, we found a significant association between a larger Pt decline and a reduced risk of second cancers and deterioration of paresthesias in hands and tinnitus.
BACKGROUND: The long-term toxicities after cisplatin-based chemotherapy (CBCT) reveal a remarkable inter-individual variation among testicular cancer survivors (TCSs). Therefore, we assessed long-term platinum (Pt) changes and their associations with CBCT-related late effects in TCSs. MATERIAL AND METHODS: In 77 TCSs treated with CBCT from 1984 to 1990, blood samples for analyses of Pt and a questionnaire including self-reported neuro- and ototoxicity (NTX) symptoms were collected during two follow-up surveys at median 12 (Survey I; SI) and 20 (Survey II; SII) years after treatment. Information about second cancers after SII was retrieved from the Norwegian Cancer Registry. RESULTS: A larger Pt decline from SI to SII was associated with a decreased risk of a second cancer diagnosis (HR 0.78, 95% CI 0.62-0.99 per 10 ng/L/year), and worsening of paresthesias in hands (OR 1.98, 95% CI 1.09-3.59 per 10 ng/L/year) and tinnitus (OR 1.51, 95% CI 1.01-2.27 per 10 ng/L/year). CONCLUSION: In summary, we found a significant association between a larger Pt decline and a reduced risk of second cancers and deterioration of paresthesias in hands and tinnitus.