Download PDF
Aktuelle Urol 2000; 31(5): 271-282
DOI: 10.1055/s-2000-7201
ÜBERSICHT
Georg Thieme Verlag Stuttgart · New York

Zentralnervöse Nebenwirkungen unter Polychemotherapie bei Patienten mit einem Hodentumor

Central Nervous Events Related to Chemotherapy in Patients with a Germ-Cell TumorC. Doehn, H. Büttner, P. Fornara, D. Jocham
  • Klinik und Poliklinik für Urologie, Medizinische Universität zu Lübeck
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Also available at
    Permissions and Reprints

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
    PubMedGoogle Scholar
  • 2 Bosl G J, Motzer R J. Testicular germ-cell cancer.  N Engl J Med. 1997;  337 242-253
    CrossrefPubMedGoogle Scholar
  • 3 Kinkade S. Testicular cancer.  Am Fam Phys. 1999;  59 2539-2544
    PubMedGoogle Scholar
  • 4 Weißbach L, Bussar-Maatz R. Pathogenese, Diagnostik und Therapie von Hodentumoren.  Urologe A. 1996;  35 163-172
    PubMedGoogle Scholar
  • 5 Landis S H, Murray T, Bolden S, Wingo P A. Cancer statistics, 1998.  CA Cancer J Clin. 1998;  48 6-29
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 7 Osterlind A. Diverging trends in incidence and mortality of testicular cancer in Denmark, 1943 - 1982.  Br J Cancer. 1986;  53 501-505
    PubMedGoogle Scholar
  • 8 Richie J P. Detection and treatment of testicular cancer.  CA Cancer J Clin. 1993;  43 151-175
    PubMedGoogle Scholar
  • 9 Nicholson P W, Harland S J. Inheritance and testicular cancer.  Br J Cancer. 1995;  71 421-426
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 11 Buetow S A. Epidemiology of testicular cancer.  Epidemiol Rev. 1995;  17 433-449
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 20 Leitlinien zur Therapie von Hodentumoren.  Urologe A. 1999;  38 201-207
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 22 Einhorn L H, Donohue J P. Advanced testicular cancer: update for urologists.  J Urol. 1998;  160 1964-1969
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 24 Doll D C, Yarbro J W. Vascular toxicity associated with antineoplastic agents.  Sem Oncol. 1992;  19 580-596
    PubMedGoogle Scholar
  • 25 Gerl A. Vascular toxicity associated with chemotherapy for testicular cancer.  Anti-Cancer Drugs. 1994;  5 607-614
    PubMedGoogle Scholar
  • 26 Einhorn L H, Donohue J P. Cisdiamminedichloroplatinum, vinblastine and bleomycin combination chemotherapy in disseminated testicular cancer.  Ann Intern Med. 1977;  87 293-298
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 28 Weise J, Köhler G, Müller J. Zur Klinik der ifosfamidinduzierten Enzephalopathie.  Tumordiagn Ther. 1997;  18 129-132
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 31 Zeller W J. Platin-Analoga. In: Zeller WJ, zur Hausen H, eds Onkologie Landsberg/Lech: ecomed 1995: IV-3.1-IV-3.16
    Google Scholar
  • 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
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 35 Wengs W J, Talwar D, Bernard J. Ifosfamide-induced nonconvulsive status epilepticus.  Arch Neurol. 1993;  50 1104-1105
    PubMedGoogle Scholar
  • 36 Bhardwaj A, Badesha P S. Ifosfamide-induced nonconvulsive status epilepticus.  Ann Pharmacother. 1995;  29 1237-1239
    PubMedGoogle Scholar
  • 37 Seegenschmiedt M H. Nebenwirkungen der Krebsbehandlung - Klassifikation und Dokumentation. In: Zeller WJ, zur Hausen H, eds Onkologie Landsberg/Lech: ecomed 1995: VII-5
    Google Scholar
  • 38 Doehn C, Büttner H, Fornara P, Jocham D. Fatal basilar artery thrombosis after chemotherapy for testicular cancer.  Urol Int. 2000;  65 43-45
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 40 Piccioli A, Prandoni P, Ewenstein B M, Goldhaber S Z. Cancer and venous thromboembolism.  Am Heart J. 1996;  132 850-855
    CrossrefPubMedGoogle Scholar
  • 41 Rosenberg R D, Aird W C. Vascular-bed-specific hemostasis and hypercoagulable states.  N Engl J Med. 1999;  340 1555-1564
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 45 Rosenfeld C S, Broder L E. Cisplatin-induced autonomic neuropathy.  Cancer Treat Rep. 1984;  68 659-660
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 49 Donati M B. Cancer and thrombosis: from phlegmasia alba dolens to transgenic mice.  Throm Haemostas. 1995;  74 278-281
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 52 Jakob A, Kollmannsberger C, Kanz L, Bokemeyer C. Spättoxizität nach Chemotherapie maligner Hodentumoren.  Urologe A. 1998;  37 635-647
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 55 Gerl A, Clemm C, Wilmanns W. Acute cerebrovascular event after cisplatin-based chemotherapy for testicular cancer.  Lancet. 1991;  338 385-386
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 66 Büttner H, Pottek T, Hartmann M. ZNS-Metastasen von Hodentumoren.  Urologe A. 1995;  S114
    PubMedGoogle Scholar
  • 67 Bamberg M, Schmoll H J, Weißbach L. Diagnostik und Therapie von Hodentumoren.  Dt Ärztebl. 1997;  94 A2742-2748
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 69 Logothetis C J, Samuels M L, Trindade A. The management of brain metastasis in germ cell tumors.  Cancer. 1982;  49 12-18
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar

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