Regular Article

British Journal of Cancer (2001) 85, 823–826. doi:10.1054/bjoc.2001.2006 www.bjcancer.com
Published online 11 September 2001

Cisplatin neurotoxicity in the treatment of metastatic germ cell tumour: time course and prognosis

M von Schlippe1, C J Fowler2 and S J Harland1,2

  1. 1Department of Oncology, University College, London, WIN 8AA
  2. 2Institute of Urology and Nephrology, University College, London, WIN 8AA, UK

Received 28 February 2001; Revised 21 June 2001; Accepted 5 July 2001.

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Abstract

In order to ascertain the incidence and prognosis of cisplatin-induced neurotoxicity in testis cancer patients undergoing combination chemotherapy, 29 patients with metastatic disease were studied prospectively. Assessments included enquiry into neurological symptoms, measurement of sural nerve sensory action potential and conduction velocity, and vibration threshold in the left big toe. At the end of chemotherapy (3 to 4 cycles) only 3 out of 26 (11%) patients had paraesthesiae, but 3 months later the proportion rose to 65%. Resolution occurred in the majority over the ensuing 12 months so that only 17% had persistent symptoms. None of the 11 patients treated with 3 cycles of chemotherapy had persisting symptoms. Vibration thresholds showed a significant deterioration during chemotherapy (P = 0.032), further deterioration in the 3 months following chemotherapy (P = 0.009) and significant improvement between 3 and 12 months after chemotherapy (P = 0.038). Sural nerve sensory action potentials and conduction velocities were unhelpful. © 2001 Cancer Research Campaign http://www.bjcancer.com

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References

  1. Ashraf M, Scotchel PL, Krall JM and Flink EB (1983) Cis-platinum-induced hypomagnesemia and peripheral neuropathy. Gynecol Oncol 16: 309–318
  2. Berger T, Malayeri R, Doppelbauer A, Krajnik G, Huber H, Auff E and Pirker R (1997) Neurological monitoring of neurotoxicity induced by paclitaxel/cisplatin chemotherapy. Euro J Cancer 33: 1393–1399
  3. Bokemeyer C, Berger CC, Kuczyk MA and Schmoll HJ (1996) Evaluation of long-term toxicity after chemotherapy for testicular cancer. J Clin Oncol 14: 2923–2932 | PubMed | ISI | ChemPort |
  4. Cavaletti G, Marzorati L, Bogliun G, Colombo N, Marzola M, Pittelli MR and Tredici G (1992) Cisplatin-induced peripheral neurotoxicity is dependent on total-dose intensity and single-dose intensity. Cancer 69: 203–207 | PubMed | ISI | ChemPort |
  5. Cavaletti G, Bogliun G, Marzorati L, Tredici G, Colombo N, Parma G and Miceli MD (1994) Long-term peripheral neurotoxicity of cisplatin in patients with succesfully treated epithelial ovarian cancer. Anticancer Res 14: 1287–1292
  6. Daugaard GK, Petrera J and Trojaborg W (1987) Electrophysiological study of the peripheral and central neurotoxic effect of cis-platin. Acta Neurol Scand 76: 86–93
  7. de Wit R, Roberts JT, Wilkinson PM, de Mulder PHM, Mead GM, Fossa SD, Cook P, de Prijck L, Stenning S and Collete L (2001) Equivalence of three or four cycles of bleomycin, etoposide and cisplatin chemotherapy and of a 3-or 5-day schedule in good-prognosis germ cell cancer: a randomised study of the European Organisation for Research and Treatment of Cancer Genitourinary Tract Cancer Co-operative Group and the Medical Research Council. J Clin Oncol 19: 1629–1640 | PubMed | ISI | ChemPort |
  8. di Benedetto M (1970) Sensory nerve conduction in lower extremeties. Arch Phys Med 51: 253–258
  9. Einhorn LH and Donohue J (1977) Cis-diammine-dichloroplatinum, vinblastine, and bleomycin combination chemotherapy in disseminated testicular cancer. Ann Intern Med 87: 293–298 | PubMed | ISI | ChemPort |
  10. Einhorn LH and Williams SD (1980) Chemotherapy of disseminated testicular cancer: a random prospective study. Cancer 46: 1339–1344 | Article | PubMed | ChemPort |
  11. Einhorn LH, Williams SD, Loehrer PJ, Birch R, Drasga R, Omuna G and Greco FA (1989) Evaluation of optimal duration of chemotherapy in favourable-prognostic disseminated germ cell tumours: bleomycin and either vinblastine or etoposide. J Clin Oncol 7: 387–391 | PubMed | ChemPort |
  12. Foster-Nora JA and Siden R (1997) Amifostine for protection from antineoplastic drug toxicity. Am J Health-System Pharm 54: 787–800
  13. Gerritsen van der Hoop R, Vecht CJ, van der Burg MEL, Elderson A, Boogerd W, Heimans JJ, Vries EP, van Houwelingen JC, Jennekens FGI, Gispen WH and Neijt JP (1990) Prevention of cisplatin neurotoxicity with an ACTH(4–9) analogue in patients with ovarian cancer. New Engl J Med 322: 89–94
  14. Grunberg SM, Sonka S, Stevenson LL and Muggia FM (1989) Progressive paresthesias after cessation of therapy with very high-dose cisplatin. Cancer Chemo Pharmacol 25: 62–64
  15. Hardaker WT, Stone RA and McCoy R (1974) Platinum nephrotoxicity. Cancer 34: 1030–1032
  16. Hilkens PHE, van der Burg MEL, Moll JWB, Planting AST, van Putten WLJ, Vecht CJ and van den Bent MJ (1995) Neurotoxicity is not enhanced by increased dose intensities of cisplatin administration. Euro J Cancer 31A: 678–681
  17. Hilkens PH, Pronk LC, Verweij J, Vecht CJ, van Putten WL and van den Bent MJ (1997) Peripheral neuropathy induced by combination chemotherapy of docetaxel and cisplatin. Brit J Cancer 75: 417–22
  18. Kaye SB, Mead GM, Fossa S, Cullen M, de Wit R, Bodrogi I, van Groeningen C, Sylvester R, Collette L, Stenning S, De Prijck L, Lallemand E and de Mulder P (1998) Intensive induction-sequential chemotherapy with BOP/VIP-B compared with treatment with BEP/EP for poor-prognosis metastatic nonseminomatous germ cell tumour: a randomised Medical Research Council/European Organisation for Research and Treatment of Cancer study. J Clin Oncol 16: 692–701 | PubMed | ISI | ChemPort |
  19. Kedar A, Cohen ME and Freeman AI (1978) Peripheral neuropathy as a complication of cis-dichlorodiammineplatinum(II) treatment: a case report. Cancer Treat Rep 62: 819–821
  20. Le Quesne PM and Fowler CJ (1987) Quantitative evaluation of toxic neuropathies in man. In: Ellingson RJ, Murray N, Halliday MThe London Symposium, EEG J Suppl 39: 347–354
  21. Mollman JE, Hogan WM, Glover DJ and McCluskey LF (1988) Unusual presentation of cis-platinum neuropathy. Neurology 38: 488–490
  22. Nielsen VK (1972) The peripheral nerve function in chronic renal failure. IV. An analysis of the vibratory perception threshold. Acta Med Scand 191: 287–296 | PubMed | ISI | ChemPort |
  23. Planting AS, Catimel G, de Mulder PH, de Graeff A, Hoeppener F, Verweij J, Oster W and Vermorken JB (1999) Randomized study of a short course of weekly cisplatin with or without amifostine in advanced head and neck cancer. EORTC Head and Neck Cooperative Group. Annal Oncol 10: 693–700
  24. Riggs JE, Ashraf M, Snyder RD and Gutmann L (1988) Prospective nerve conduction studies in cisplatin therapy. Annal Neurol 23: 92–94
  25. Steiness IB (1957a) Vibratory perception in normal subjects. A biothesiometric study. Acta Med Scand 158: 315–325
  26. Steiness IB (1957b) Vibratory perception in diabetics. A biothesiometric study. Acta Med Scand 158: 327–335
  27. von Schlippe M, Fowler CJ and Harland SJ (1998) Cisplatin Neurotoxicity. In: Jones WG, Appleyard I, Harnden P, Joffe JK eds. Germ Cell Tumours IV. John Libbey & Co. Ltd