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Long-term neurotoxicity and quality of life in testicular cancer survivors-a nationwide cohort study

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@article{62b14a54a3c54c11b162ae2a49228188,
title = "Long-term neurotoxicity and quality of life in testicular cancer survivors-a nationwide cohort study",
abstract = "PURPOSE: To evaluate neurotoxicity in testicular cancer survivors (TCSs) years after treatment and secondly the influence of neurotoxicity on quality-of-life (QoL).METHODS: We identified 2234 TCSs who completed the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity questionnaire. QoL was evaluated with the European Organization for Research and Treatment of Cancer QLQ-C30. Patients were grouped according to treatment strategy: surveillance (N = 1113), infradiaphragmatic radiotherapy (N = 301), cisplatin-etoposide-bleomycin (BEP) (N = 759), and more than one line of treatment (MTOL) (N = 61). Association of treatment modality with long-term neurotoxicity was analyzed with ordinal logistic regression. Secondly, associations between neurotoxicity and QoL were analyzed in BEP-treated patients. Analyses were age-adjusted and repeated with additional adjustment for comorbidity, smoking, and alcohol consumption.RESULTS: After a median follow-up of 18.4 years, treatment with BEP and MTOL was associated with overall increased risk of neurotoxicity (odds ratio 2.4-4.7 depending on treatment intensity, P < 0.001) as well as subscales (peripheral neuropathy, ototoxicity, and dysfunction associated with neuropathy, all P < 0.001). Radiotherapy and surveillance were not associated with neurotoxicity. In patients treated with BEP, neurotoxicity was highly associated with all indicators of worse QoL outcomes (P-trend: 1.5 × 10-17 to 1.1 × 10-28) after almost 20 years of follow-up.CONCLUSIONS: Treatment with BEP was associated with long-term neurotoxicity, which was highly associated with decreased QoL. Strategies to ameliorate or prevent neurotoxicity should be investigated.IMPLICATIONS FOR CANCER SURVIVORS: Treatment with chemotherapy for testicular cancer induces long-term neuro- and ototoxicity which may have severe influence on quality-of-life years after treatment cessation.",
keywords = "Cisplatin, Neurotoxicity, Testicular cancer, Quality of life",
author = "Jakob Lauritsen and Mikkel Bandak and Michael Kreiberg and Sk{\o}tt, {Julie Wang} and Thomas Wagner and Rosenvilde, {Josephine Julie} and Lars Dysager and Mads Agerb{\ae}k and Gedske Daugaard",
year = "2021",
month = aug,
doi = "10.1007/s11764-020-00944-1",
language = "English",
volume = "15",
pages = "509--517",
journal = "Journal of Cancer Survivorship",
issn = "1932-2259",
publisher = "Springer New York LLC",
number = "4",

}

RIS

TY - JOUR

T1 - Long-term neurotoxicity and quality of life in testicular cancer survivors-a nationwide cohort study

AU - Lauritsen, Jakob

AU - Bandak, Mikkel

AU - Kreiberg, Michael

AU - Skøtt, Julie Wang

AU - Wagner, Thomas

AU - Rosenvilde, Josephine Julie

AU - Dysager, Lars

AU - Agerbæk, Mads

AU - Daugaard, Gedske

PY - 2021/8

Y1 - 2021/8

N2 - PURPOSE: To evaluate neurotoxicity in testicular cancer survivors (TCSs) years after treatment and secondly the influence of neurotoxicity on quality-of-life (QoL).METHODS: We identified 2234 TCSs who completed the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity questionnaire. QoL was evaluated with the European Organization for Research and Treatment of Cancer QLQ-C30. Patients were grouped according to treatment strategy: surveillance (N = 1113), infradiaphragmatic radiotherapy (N = 301), cisplatin-etoposide-bleomycin (BEP) (N = 759), and more than one line of treatment (MTOL) (N = 61). Association of treatment modality with long-term neurotoxicity was analyzed with ordinal logistic regression. Secondly, associations between neurotoxicity and QoL were analyzed in BEP-treated patients. Analyses were age-adjusted and repeated with additional adjustment for comorbidity, smoking, and alcohol consumption.RESULTS: After a median follow-up of 18.4 years, treatment with BEP and MTOL was associated with overall increased risk of neurotoxicity (odds ratio 2.4-4.7 depending on treatment intensity, P < 0.001) as well as subscales (peripheral neuropathy, ototoxicity, and dysfunction associated with neuropathy, all P < 0.001). Radiotherapy and surveillance were not associated with neurotoxicity. In patients treated with BEP, neurotoxicity was highly associated with all indicators of worse QoL outcomes (P-trend: 1.5 × 10-17 to 1.1 × 10-28) after almost 20 years of follow-up.CONCLUSIONS: Treatment with BEP was associated with long-term neurotoxicity, which was highly associated with decreased QoL. Strategies to ameliorate or prevent neurotoxicity should be investigated.IMPLICATIONS FOR CANCER SURVIVORS: Treatment with chemotherapy for testicular cancer induces long-term neuro- and ototoxicity which may have severe influence on quality-of-life years after treatment cessation.

AB - PURPOSE: To evaluate neurotoxicity in testicular cancer survivors (TCSs) years after treatment and secondly the influence of neurotoxicity on quality-of-life (QoL).METHODS: We identified 2234 TCSs who completed the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity questionnaire. QoL was evaluated with the European Organization for Research and Treatment of Cancer QLQ-C30. Patients were grouped according to treatment strategy: surveillance (N = 1113), infradiaphragmatic radiotherapy (N = 301), cisplatin-etoposide-bleomycin (BEP) (N = 759), and more than one line of treatment (MTOL) (N = 61). Association of treatment modality with long-term neurotoxicity was analyzed with ordinal logistic regression. Secondly, associations between neurotoxicity and QoL were analyzed in BEP-treated patients. Analyses were age-adjusted and repeated with additional adjustment for comorbidity, smoking, and alcohol consumption.RESULTS: After a median follow-up of 18.4 years, treatment with BEP and MTOL was associated with overall increased risk of neurotoxicity (odds ratio 2.4-4.7 depending on treatment intensity, P < 0.001) as well as subscales (peripheral neuropathy, ototoxicity, and dysfunction associated with neuropathy, all P < 0.001). Radiotherapy and surveillance were not associated with neurotoxicity. In patients treated with BEP, neurotoxicity was highly associated with all indicators of worse QoL outcomes (P-trend: 1.5 × 10-17 to 1.1 × 10-28) after almost 20 years of follow-up.CONCLUSIONS: Treatment with BEP was associated with long-term neurotoxicity, which was highly associated with decreased QoL. Strategies to ameliorate or prevent neurotoxicity should be investigated.IMPLICATIONS FOR CANCER SURVIVORS: Treatment with chemotherapy for testicular cancer induces long-term neuro- and ototoxicity which may have severe influence on quality-of-life years after treatment cessation.

KW - Cisplatin

KW - Neurotoxicity

KW - Testicular cancer

KW - Quality of life

U2 - 10.1007/s11764-020-00944-1

DO - 10.1007/s11764-020-00944-1

M3 - Journal article

C2 - 32978721

VL - 15

SP - 509

EP - 517

JO - Journal of Cancer Survivorship

JF - Journal of Cancer Survivorship

SN - 1932-2259

IS - 4

ER -

ID: 61506612