Zusammenfassung
Zu den Nebenwirkungen der cisplatinbasierten Polychemotherapie gehören in seltenen Fällen auch vaskuläre Ereignisse wie Thrombosen, Embolien sowie Myokard- oder Hirninfarkte. Weiterhin sind zentralnervöse Nebenwirkungen zytostatischer Medikamente wie Hemiparese, epileptischer Anfall bis hin zum Koma beschrieben worden. In der vorliegenden Arbeit wird eine Übersicht zur verfügbaren Literatur zentralnervöser Nebenwirkungen unter Polychemotherapie bei Patienten mit einem Hodentumor gegeben. Dieser Aspekt muss insbesondere auch bei der Aufklärung des Patienten Berücksichtigung finden. Dies ist um so wichtiger, als bei zentralnervösen Komplikationen potenziell letale Gefahren für den Patienten drohen.
Abstract
The complications related to cisplatin-based chemotherapy include vascular events such as thrombosis and myocardial or cerebral infarction. Additionally, central nervous side effects like hemiparesis, status epilepticus and coma have been reported. This review provides an overview of the central nervous side effects during or after chemotherapy for germ-cell tumor. This aspect must be also mentioned in the informed consent for chemotherapy since these side effects are potentially lethal.
Key words
Germ-cell tumor - Chemotherapy - Cisplatin - Central nervous symptoms - Cerebrovascular event - Basilar artery thrombosis - Status epilepticus
Literatur
-
1
Devesa S S, Blot W J, Stone B J, Miller B A, Tarone R E, Fraumeni Jr J F.
Recent cancer trends in the United States.
J Natl Cancer Inst.
1995;
87
175-182
-
2
Bosl G J, Motzer R J.
Testicular germ-cell cancer.
N Engl J Med.
1997;
337
242-253
-
3
Kinkade S.
Testicular cancer.
Am Fam Phys.
1999;
59
2539-2544
-
4
Weißbach L, Bussar-Maatz R.
Pathogenese, Diagnostik und Therapie von Hodentumoren.
Urologe A.
1996;
35
163-172
-
5
Landis S H, Murray T, Bolden S, Wingo P A.
Cancer statistics, 1998.
CA Cancer J Clin.
1998;
48
6-29
-
6
McKiernan J M, Goluboff E T, Liberson G L, Golden R, Fisch H.
Rising risk of testicular cancer by birth cohort in the United States form 1973 to 1995.
J Urol.
1999;
162
361-363
-
7
Osterlind A.
Diverging trends in incidence and mortality of testicular cancer in Denmark, 1943 - 1982.
Br J Cancer.
1986;
53
501-505
-
8
Richie J P.
Detection and treatment of testicular cancer.
CA Cancer J Clin.
1993;
43
151-175
-
9
Nicholson P W, Harland S J.
Inheritance and testicular cancer.
Br J Cancer.
1995;
71
421-426
-
10
Benson Jr R C, Beard C M, Kelalis P P, Kurland L T.
Malignant potential of the cryptorchid testis.
Mayo Clin Proc.
1991;
66
372-378
-
11
Buetow S A.
Epidemiology of testicular cancer.
Epidemiol Rev.
1995;
17
433-449
-
12
Møller H, Skakkebæk N E.
Risks of testicular cancer and cryptorchidism in relation to socio-economic status and related factors: case-control studies in Denmark.
Int J Cancer.
1996;
66
287-293
-
13
Swerdlow A J, Higgins C D, Pike M C.
Risk of testicular cancer in cohort of boys with cryptorchidism.
BMJ.
1997;
314
1507-1511
-
14
Dieckmann K P, Pichlmeier U.
The prevalence of familial testicular cancer: an analysis of two patient populations and a review of the literature.
Cancer.
1997;
80
1954-1960
-
15 Richie J P. Neoplasms of the testis. In: Walsh PC, Retik AB, Vaughan Jr ED, Wein AJ, eds Campbell's Urology, 7th Edition Philadelphia: WB Saunders 1998: 2411-2452
-
16
International Germ Cell Cancer Collaborative Group .
International germ cell consensus classification: a prognostic factor-based staging system for metastatic germ cell cancers.
J Clin Oncol.
1997;
15
594-603
-
17
Bredael J J, Vugrin D, Whitmore Jr W F.
Autopsy findings in 154 patients with germ cell tumors of the testis.
Cancer.
1982;
50
548-551
-
18
Bower M, Newlands E S, Holden L, Rustin G J, Begent R H.
Treatment of men with metastatic non-seminomatous germ cell tumours with cyclical POMB/ACE chemotherapy.
Ann Oncol.
1997;
8
477-483
-
19
Sonneveld D JA, Hoekstra H J, van der Graaf W TA, Sluiter W J, Schrafford Koops H, Sleijfer D T.
The changing distribution of stage in nonseminomatous testicular germ cell tumours, from 1977 to 1996.
BJU International.
1999;
84
68-74
-
20
Leitlinien zur Therapie von Hodentumoren.
Urologe A.
1999;
38
201-207
-
21
Aareleid T, Sant M, Hedelin G. and the Euro Care Group .
Improved survival for patients with testicular cancer in Europe since 1978.
Eur J Cancer.
1998;
34
2236-2240
-
22
Einhorn L H, Donohue J P.
Advanced testicular cancer: update for urologists.
J Urol.
1998;
160
1964-1969
-
23
Gerl A, Sauer H, Liedl B, Hiddemann W.
The therapy of testicular tumors 2 decades after the introduction of cisplatin.
Dtsch Med Wochenschr.
2000;
125
327-334
-
24
Doll D C, Yarbro J W.
Vascular toxicity associated with antineoplastic agents.
Sem Oncol.
1992;
19
580-596
-
25
Gerl A.
Vascular toxicity associated with chemotherapy for testicular cancer.
Anti-Cancer Drugs.
1994;
5
607-614
-
26
Einhorn L H, Donohue J P.
Cisdiamminedichloroplatinum, vinblastine and bleomycin combination chemotherapy in disseminated testicular cancer.
Ann Intern Med.
1977;
87
293-298
-
27
Williams S D, Birch R, Einhorn L H, Irwin L, Greco F A, Loehrer P J.
Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposid.
N Engl J Med.
1987;
316
1435-1440
-
28
Weise J, Köhler G, Müller J.
Zur Klinik der ifosfamidinduzierten Enzephalopathie.
Tumordiagn Ther.
1997;
18
129-132
-
29
Brennecke H J, Weinknecht S, Finck G A, Mitlehner W, Weissbach L.
Rare metabolic and cerebral complications after polychemotherapy of a testicular cancer.
Urologe A.
1994;
33
484-486
-
30
Rosenberg B, Van Camp L, Krigas T.
Inhibition of cell division in Escherichia coli by electrolysis products from a platinum electrode.
Nature.
1965;
205
698-699
-
31 Zeller W J. Platin-Analoga. In: Zeller WJ, zur Hausen H, eds Onkologie Landsberg/Lech: ecomed 1995: IV-3.1-IV-3.16
-
32 Chabner B A, Allegra C J, Curt G A, Calabresi P. Antineoplastic agents. In: Hardman JG, Gilman AG, Limbird LE, eds Goodman & Gilman's The pharmacological basis of therapeutics, 9th Edition New York: McGraw-Hill 1996: 1233-1287
-
33
Takano S, Saitoh M, Ohbu M, Miyasaka Y, Yada K, Takagi H.
Brain metastasis of testicular yolk sac tumor with massive hemorrhage: case report.
No Shinkei Geka.
1993;
21
533-537
-
34
Doll D C, List A F, Greco F A, Hainsworth J D, Hande K R, Johnson D H.
Acute vascular ischemic events after cisplatin-based combination chemotherapy for germ-cell tumors of the testis.
Ann Intern Med.
1986;
105
48-51
-
35
Wengs W J, Talwar D, Bernard J.
Ifosfamide-induced nonconvulsive status epilepticus.
Arch Neurol.
1993;
50
1104-1105
-
36
Bhardwaj A, Badesha P S.
Ifosfamide-induced nonconvulsive status epilepticus.
Ann Pharmacother.
1995;
29
1237-1239
-
37 Seegenschmiedt M H. Nebenwirkungen der Krebsbehandlung - Klassifikation und Dokumentation. In: Zeller WJ, zur Hausen H, eds Onkologie Landsberg/Lech: ecomed 1995: VII-5
-
38
Doehn C, Büttner H, Fornara P, Jocham D.
Fatal basilar artery thrombosis after chemotherapy for testicular cancer.
Urol Int.
2000;
65
43-45
-
39
Sarasin F P, Eckman M H.
Management and prevention of thrombembolic events in patients with cancer-related hypercogulable states: a risky business.
J Gen Intern Med.
1993;
8
476-486
-
40
Piccioli A, Prandoni P, Ewenstein B M, Goldhaber S Z.
Cancer and venous thromboembolism.
Am Heart J.
1996;
132
850-855
-
41
Rosenberg R D, Aird W C.
Vascular-bed-specific hemostasis and hypercoagulable states.
N Engl J Med.
1999;
340
1555-1564
-
42
Shlebak A A, Smith D B.
Incidence of objectively diagnosed thrombembolic disease in cancer patients undergoing cytotoxic chemotherapy and/or hormonal therapy.
Cancer Chemother Pharmacol.
1997;
39
462-466
-
43
Lemmers N WM, Gels M E, Sleijfer D T, Plukker J T, van der Graaf W TA, de langen Z J, Droste J HJ, Schraffordt Koops H, Hoekstra H J.
Complications with venous access ports in 132 patients with disseminated testicular cancer treated with polychemotherapy.
J Clin Oncol.
1996;
14
2916-2922
-
44
Turlapaty P D, Altura B M.
Magnesium deficiency produces spasms of coronary arteries: relationship to etiology of sudden death ischemic heart disease.
Science.
1980;
208
198-200
-
45
Rosenfeld C S, Broder L E.
Cisplatin-induced autonomic neuropathy.
Cancer Treat Rep.
1984;
68
659-660
-
46
Roca E, Bruera E, Politi P M, Barugel M, Cedaro L, Carraro S, Chacon R D.
Vinca alkaloid-induced cardiovascular autonomic neuro-pathy.
Cancer Treat Rep.
1985;
69
149-151
-
47
Fossa S D, Aass N, Kaalhus O, Klepp O, Tveter K.
Long-term survival and morbidity in patients with metastatic malignant germ cell tumours treated with cisplatin-based combination chemotherapy.
Cancer.
1986;
58
2600-2605
-
48
von Tempelhoff G F, Niemann F, Schneider D M, Kirkpatrick C J, Hommel G, Heilmann L.
Blood rheology during chemotherapy in patients with ovarian cancer.
Throm Res.
1998;
90
73-82
-
49
Donati M B.
Cancer and thrombosis: from phlegmasia alba dolens to transgenic mice.
Throm Haemostas.
1995;
74
278-281
-
50
Vogelzang N J, Bosl G J, Johnson K, Kennedy B J.
Raynaud's phenomenon: a common toxicity after combination chemotherapy for testicular cancer.
Ann Intern Med.
1981;
95
288-292
-
51
Berger C C, Boekemeyer C, Schneider M, Kuczyk M A, Schmoll H J.
Secondary Raynaud's phenomenon and other late vascular complications following chemotherapy for testicular cancer.
Eur J Cancer.
1995;
31A
2229-2238
-
52
Jakob A, Kollmannsberger C, Kanz L, Bokemeyer C.
Spättoxizität nach Chemotherapie maligner Hodentumoren.
Urologe A.
1998;
37
635-647
-
53
Licciardello J T, Moake J L, Rudy C K, Karp D D, Hong W K.
Elevated plasma von Willebrand factor levels and arterial occlusive complications associated with cisplatin-based chemotherapy.
Oncology.
1985;
42
296-300
-
54
Samuels B L, Vogelzang N J, Kennedy B J.
Severe vascular toxicity associated with vinblastine, bleomycin, and cisplatin chemotherapy.
Cancer Chemother Pharmacol.
1987;
19
253-256
-
55
Gerl A, Clemm C, Wilmanns W.
Acute cerebrovascular event after cisplatin-based chemotherapy for testicular cancer.
Lancet.
1991;
338
385-386
-
56
Gerl A, Clemm C, Schleuning M, Wilmanns W.
Fatal cerebrovascular accident associated with chemotherapy for testicular cancer.
Eur J Cancer.
1993;
29A
1220-1221
-
57
Icli F, Karaoguz H, Dincol D, Demikazik A, Günel N, Karaoguz R, Üner A.
Severe vascular toxicity associated with cisplatin-based chemotherapy.
Cancer.
1993;
72
587-593
-
58
Coates A S, Childs A, Cox K, Forsyth C, Joshua D E, McNeil E, Grygiel J J.
Severe vascular adverse effects with thrombocytopenia and renal failure following emetgenic chemotherapy and ondansetron.
Ann Oncol.
1992;
3
719-722
-
59
Cantwell B MJ, Mannix K A, Roberts J T, Ghani S E, Harris A L.
Thrombembolic events during combination chemotherapy for germ cell malignancy.
Lancet.
1988;
II
1086-1087
-
60
Cullen M H, Stenning S P, Parkinson M C, Fossa S D, Kaye S B, Horwich A H, Harland S J, Williams M V, Jakes R.
Short-course adjuvant chemotherapy in high-risk stage I nonseminomatous germ cell tumors of the testis: a medical research council report.
J Clin Oncol.
1996;
14
1106-1113
-
61
Fossa S D, Droz J P, Stoter G, Kaye S B, Vermeylen K, Sylvester R.
Cisplatin, vincristine and ifosphamide combination chemotherapy of metastatic seminoma: results of EORTC trial 30874. EORTC GU Group.
Br J Cancer.
1995;
71
619-624
-
62
Nichols C R, Roth B J, Williams S D, Gill I, Muggia F M, Stablein D M, Weiss R B, Einhorn L H.
No evidence of acute cardiovascular complications of chemotherapy for testicular cancer: an analysis of the Testicular Cancer Intergroup Study.
J Clin Oncol.
1992;
10
760-765
-
63
Aeschlimann C, Kupfer A, Schefer H, Cerny T.
Comparative pharmacokinetics of oral and intravenous ifosfamide/mesna/methylene blue therapy.
Drug Metab Dispos.
1998;
26
883-890
-
64
Pelgrims J, De Vos F, Van den Brande J, Schrijvers D, Prove A, Vermorken J B.
Methylene blue in the treatment and prevention of ifosfamide-induced encephalopathy: report of 12 cases and a review of the literature.
Br J Cancer.
1999;
82
291-294
-
65
Kellner O, Dempke W, Schmoll H J.
Glukose-Infusionen - eine mögliche effektive Therapieoption bei der Ifosfamid-induzierten Enzephalopathie.
Dtsch Med Wschr.
1999;
124
1086
-
66
Büttner H, Pottek T, Hartmann M.
ZNS-Metastasen von Hodentumoren.
Urologe A.
1995;
S114
-
67
Bamberg M, Schmoll H J, Weißbach L.
Diagnostik und Therapie von Hodentumoren.
Dt Ärztebl.
1997;
94
A2742-2748
-
68
Nussbaum E S, Djalilan H R, Cho K H, Hall W A.
Brain Metastases. Histology, Multiplicity, Surgery, and Survival.
Cancer.
1996;
78
1781-1788
-
69
Logothetis C J, Samuels M L, Trindade A.
The management of brain metastasis in germ cell tumors.
Cancer.
1982;
49
12-18
-
70
Mahalati K, Bilen C Y, Ozen H, Aki F T, Kendi S.
The management of brain metastasis in nonseminomatous germ cell tumours.
BJU Int.
1999;
83
457-461
-
71
Fossa S D, Bokemeyer C, Gerl A, Culine S, Jones W G, Mead G M, Germa-Luch J R, Pont J, Schmoll H J, Tjuladin S.
Treatment outcome of patients with brain metastasis from malignant germ cell tumors.
Cancer.
1999;
85
988-997
Dr. med C Doehn
Oberarzt der Klinik und Poliklinik für Urologie, Medizinische Universität zu Lübeck
Ratzeburger Allee 160 23538 Lübeck
Email: E-mail: doehn@medinf.mu-luebeck.de
