Department of Urology, Albertinen-Krankenhaus Hamburg, Hamburg.
Onkologische Schwerpunktpraxis München, Munich.
Ann Oncol. 2010 Aug;21(8):1607-1611. doi: 10.1093/annonc/mdp597. Epub 2010 Jan 12.
Chronic vascular morbidity resulting from chemotherapy for testicular germ-cell cancer (TGCC) is recognized. Cardiovascular events (CVEs) occurring early during chemotherapy are less understood. We evaluated the incidence and clinical features of CVEs associated with chemotherapy of TGCC.
A questionnaire was sent to 355 institutions in Germany to explore for early CVEs occurring during 1996-2008. To assess the relative incidence of CVEs, the number of events was put into relation to the total number of patients treated during the time span (n = 8233, calculated from national database). The response rate was 79%.
Twenty cases with myocardial infarction (MI), 3 with cerebral stroke, and 2 with arterial thrombosis were recorded. The estimated incidence of MI and of all CVEs during chemotherapy is 0.24% [95% confidence intervals (CIs) 0.137% to 0.349%] and 0.30% (95% CI 0.188% to 0.423%), respectively. This estimate represents a minimum figure because the calculation is on the basis of simplifications. Six MI patients had no risk factors. Coronary angiography was indicative of thromboembolic rather than atherosclerotic origin of MI.
There is a small but definite risk of major early CVE associated with chemotherapy of TGCC. Physicians caring for TGCC patients must be aware of this hazard.
化疗引起的睾丸生殖细胞癌（TGCC）慢性血管病变已得到公认。人们对化疗期间早期发生的心血管事件（CVE）了解较少。我们评估了与 TGCC 化疗相关的 CVE 的发生率和临床特征。
向德国 355 家机构发送了一份问卷，以调查 1996-2008 年期间发生的早期 CVE。为了评估 CVE 的相对发生率，将事件数量与治疗期间的总患者人数（n = 8233，根据国家数据库计算得出）进行了比较。回复率为 79%。
记录到 20 例心肌梗死（MI）、3 例脑卒中和 2 例动脉血栓形成。化疗期间 MI 和所有 CVE 的估计发生率分别为 0.24%（95%置信区间 0.137%至 0.349%）和 0.30%（95%置信区间 0.188%至 0.423%）。由于计算是基于简化，这个估计只是一个最低数字。6 名 MI 患者没有风险因素。冠状动脉造影显示 MI 的血栓栓塞而非动脉粥样硬化起源。
与 TGCC 化疗相关的主要早期 CVE 存在一定风险，但风险较小。治疗 TGCC 患者的医生必须意识到这一危害。
