The Sound of Silence: A Proxy for Platinum Toxicity

Oldenburg, Jan; Gietema, Jourik A.

doi:10.1200/jco.2016.68.2476

Cited by 13 publications

(13 citation statements)

References 29 publications

(19 reference statements)

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“…The authors noted that among 488 men treated with CBCT, 80% had a hearing loss according to the ASHA criteria, of whom 18% had a severe to profound hearing loss. In agreement with the accompanying editorial comment [10], we question whether the ASHA criteria are adequate for the identification of a clinical significant hearing loss, and to what degree CBCT contributes to the age-related hearing loss. The aims of the present longitudinal study were to evaluate (1) hearing threshold levels (HTLs) in audiograms pretreatment, during chemotherapy and at follow-up survey, (2) audiogramdefined hearing loss according to different criteria and (3) self-reported hearing impairment and tinnitus at survey in 46 men treated for TC with CBCT.…”

Section: Introductionmentioning

confidence: 61%

Hearing loss before and after cisplatin-based chemotherapy in testicular cancer survivors: a longitudinal study

et al. 2018

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Section: Introductionmentioning

confidence: 61%

Hearing loss before and after cisplatin-based chemotherapy in testicular cancer survivors: a longitudinal study

et al. 2018

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“…Such characterization is important to develop risk-stratified, evidence-based follow-up recommendations. Moreover, as noted previously, 8 a better understanding of AHOs may help to guide testicular cancer management, especially in the controversial area of whether good-risk patients should receive EP 3 4 or BEP 3 3.…”

Section: Introductionmentioning

confidence: 80%

“…In a curable disease such as testicular cancer with a long life expectancy and equivalent therapy options, the availability of AHO data becomes increasingly important to inform treatment decisions. 8 The striking association between CBM score and self-reported health indicates that the score captures outcomes that affect patients' self-perception of health. The risk of worse self-reported health among patients with very high/severe CBM scores rose to .…”

Section: Jcoorgmentioning

confidence: 99%

Cumulative Burden of Morbidity Among Testicular Cancer Survivors After Standard Cisplatin-Based Chemotherapy: A Multi-Institutional Study

Kerns¹,

Fung²,

Monahan³

et al. 2018

JCO

101

106

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Purpose In this multicenter study, we evaluated the cumulative burden of morbidity (CBM) among > 1,200 testicular cancer survivors and applied factor analysis to determine the co-occurrence of adverse health outcomes (AHOs). Patients and Methods Participants were ≤ 55 years of age at diagnosis, finished first-line chemotherapy ≥ 1 year previously, completed a comprehensive questionnaire, and underwent physical examination. Treatment data were abstracted from medical records. A CBM score encompassed the number and severity of AHOs, with ordinal logistic regression used to assess associations with exposures. Nonlinear factor analysis and the nonparametric dimensionality evaluation to enumerate contributing traits procedure determined which AHOs co-occurred. Results Among 1,214 participants, approximately 20% had a high (15%) or very high/severe (4.1%) CBM score, whereas approximately 80% scored medium (30%) or low/very low (47%). Increased risks of higher scores were associated with four cycles of either ifosfamide, etoposide, and cisplatin (odds ratio [OR], 1.96; 95% CI, 1.04 to 3.71) or bleomycin, etoposide, and cisplatin (OR, 1.44; 95% CI, 1.04 to 1.98), older attained age (OR, 1.18; 95% CI, 1.10 to 1.26), current disability leave (OR, 3.53; 95% CI, 1.57 to 7.95), less than a college education (OR, 1.44; 95% CI, 1.11 to 1.87), and current or former smoking (OR, 1.28; 95% CI, 1.02 to 1.63). CBM score did not differ after either chemotherapy regimen ( P = .36). Asian race (OR, 0.41; 95% CI, 0.23 to 0.72) and vigorous exercise (OR, 0.68; 95% CI, 0.52 to 0.89) were protective. Variable clustering analyses identified six significant AHO clusters (χ P < .001): hearing loss/damage, tinnitus (OR, 16.3); hyperlipidemia, hypertension, diabetes (OR, 9.8); neuropathy, pain, Raynaud phenomenon (OR, 5.5); cardiovascular and related conditions (OR, 5.0); thyroid disease, erectile dysfunction (OR, 4.2); and depression/anxiety, hypogonadism (OR, 2.8). Conclusion Factors associated with higher CBM may identify testicular cancer survivors in need of closer monitoring. If confirmed, identified AHO clusters could guide the development of survivorship care strategies.

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“…7,8 Given the curative potential of these commonly used regimens, it has become increasingly important to understand the occurrence of long-term adverse health outcomes (AHOs). As recently pointed out by Oldenburg and Gietema, 9 better characterization of AHOs may also help guide TC treatment, especially in the controversial area of whether patients with good-risk TC should receive EPX4 or BEPX3. However, no series to date has quantified the type and prevalence of long-term AHOs in large numbers of patients treated with EPX4, BEPX3, or BEPX4.…”

Section: Introductionmentioning

confidence: 99%

“…Because alterations in the successful TC regimens are unlikely, our results underscore the importance of continued follow-up of TCSs to determine the extent to which AHOs might increase as the cohort matures. 9 Similarly, ongoing genetic research to broaden our understanding of the biologic basis and causal pathways of cisplatin-associated AHOs 44,45,59 is needed to form the foundation for the development of preventive and interventional strategies. Although increasing numbers of AHOs were associated with a significant decline in self-reported health, 2 ) for one (n = 288), two (n = 185), and three (n = 84) AHOs compared with no AHOs were 1.14 (95% CI, 0.87 to 1.49), P = .34; 1.48 (95% CI, 1.11 to 1.97), P = .01; and 1.46 (95% CI, 1.002 to 2.13), P = .05.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Multi-Institutional Assessment of Adverse Health Outcomes Among North American Testicular Cancer Survivors After Modern Cisplatin-Based Chemotherapy

Fung

Sesso

Williams

et al. 2017

JCO

108

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To provide new information on adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) after four cycles of etoposide and cisplatin (EPX4) or three or four cycles of bleomycin, etoposide, cisplatin (BEPX3/BEPX4). MethodsNine hundred fifty-two TCSs . 1 year postchemotherapy underwent physical examination and completed a questionnaire. Multinomial logistic regression estimated AHOs odds ratios (ORs) in relation to age, cumulative cisplatin and/or bleomycin dose, time since chemotherapy, sociodemographic factors, and health behaviors. ResultsMedian age at evaluation was 37 years; median time since chemotherapy was 4.3 years. Chemotherapy consisted largely of BEPX3 (38.2%), EPX4 (30.9%), and BEPX4 (17.9%). None, one to two, three to four, or five or more AHOs were reported by 20.4%, 42.0%, 25.1%, and 12.5% of TCSs, respectively. Median number after EPX4 or BEPX3 was two (range, zero to nine and zero to 11, respectively; P . .05) and two (range, zero to 10) after BEPX4. When comparing individual AHOs for EPX4 versus BEPX3, Raynaud phenomenon (11.6% v 21.4%; P , .01), peripheral neuropathy (29.2% v 21.4%; P = .02), and obesity (25.5% v 33.0%; P = .04) differed. Larger cumulative bleomycin doses (OR, 1.44 per 90,000 IU) were significantly associated with five or more AHOs. Increasing age was a significant risk factor for one to two, three to four, or five or more AHOs versus zero AHOs (OR, 1.22, 1.50, and 1.87 per 5 years, respectively; P , .01); vigorous physical activity was protective (OR, 0.62, 0.51, and 0.41, respectively; P , .05). Significant risk factors for three to four and five or more AHOs included current (OR, 3.05 and 3.73) or former (OR, 1.61 and 1.76) smoking (P , .05). Self-reported health was excellent/very good in 59.9% of TCSs but decreased as AHOs increased (P , .001). ConclusionNumbers of AHOs after EPX4 or BEPX3 appear similar, with median follow-up of 4.3 years. A healthy lifestyle was associated with reduced number of AHOs.

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The Sound of Silence: A Proxy for Platinum Toxicity

Cited by 13 publications

References 29 publications

Hearing loss before and after cisplatin-based chemotherapy in testicular cancer survivors: a longitudinal study

Hearing loss before and after cisplatin-based chemotherapy in testicular cancer survivors: a longitudinal study

Cumulative Burden of Morbidity Among Testicular Cancer Survivors After Standard Cisplatin-Based Chemotherapy: A Multi-Institutional Study

Multi-Institutional Assessment of Adverse Health Outcomes Among North American Testicular Cancer Survivors After Modern Cisplatin-Based Chemotherapy

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