Hematology and Oncology, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, RT 473, Indianapolis, IN, 46202, USA.
Larner College of Medicine, University of Vermont, Burlington, VT, 05405, USA.
Support Care Cancer. 2020 Jul;28(7):3165-3170. doi: 10.1007/s00520-019-05117-0. Epub 2019 Nov 9.
It is important to assess the prevalence of hypogonadism and to identify the correlation between hypogonadism and cancer treatment with quality of life (QoL) in germ cell tumor (GCT) survivors.
This is a single-center, non-randomized, prospective observational study in GCT survivors 18-50 years of age previously treated with surgery and chemotherapy (S+C) or surgery alone (S). Patients completed a validated QoL questionnaire at baseline, 3, and 6 months. Patients received supplemental testosterone as clinically indicated. Mean QoL scores were compared between two treatment groups (S+C vs. S) and within each group between survivors with hypogonadism (serum testosterone level < 300 ng/dL) versus without. A two-sided independent-groups t test was used to compare means.
We evaluated 199 GCT survivors. At baseline, the prevalence of biochemical hypogonadism was 48% overall, 51% in S+C group, and 45% in S group (p = .4). Overall, there was no statistically significant difference in QoL scores between S+C and C groups, except the S+C group exhibited greater modified Aging Male Symptoms (AMS) at baseline and 6 months. Patients with hypogonadism reported more fatigue, poor sleep quality, and worse general health at baseline. There were no statistical differences in mean QOL scores between patients with testosterone < 300 ng/dL who received testosterone supplementation and who did not.
A significant proportion of GCT survivors have low testosterone levels after platinum-based chemotherapy and surgery as well as with just surgery alone. GCT survivors treated with platinum-based chemotherapy exhibited more symptoms related to male aging compared with survivors treated with surgery alone.
评估性腺功能减退症的患病率，并确定其与癌症治疗与生活质量（QoL）之间的相关性，对于生殖细胞瘤（GCT）幸存者非常重要。
这是一项单中心、非随机、前瞻性观察研究，纳入了年龄在 18-50 岁之间的 GCT 幸存者，他们先前接受了手术和化疗（S+C）或单纯手术（S）治疗。患者在基线、3 个月和 6 个月时完成了一份经过验证的 QoL 问卷。根据临床指征，为患者补充睾酮。在两个治疗组（S+C 与 S）之间以及每组内，将血清睾酮水平<300ng/dL 的性腺功能减退症患者与无性腺功能减退症患者的 QoL 评分均值进行比较。使用双侧独立样本 t 检验比较均值。
我们评估了 199 名 GCT 幸存者。在基线时，总的生化性腺功能减退症患病率为 48%，S+C 组为 51%，S 组为 45%（p=0.4）。总体而言，S+C 组和 C 组之间的 QoL 评分没有统计学上的显著差异，只是 S+C 组在基线和 6 个月时表现出更大的改良男性衰老症状（AMS）。性腺功能减退症患者在基线时报告疲劳、睡眠质量差和总体健康状况更差。血清睾酮<300ng/dL 的患者中，接受睾酮补充治疗与未接受补充治疗的患者之间的 QOL 评分均值没有统计学差异。
相当一部分 GCT 幸存者在接受铂类化疗和手术后，以及单纯手术后，其睾酮水平较低。与单纯手术治疗的幸存者相比，接受铂类化疗治疗的 GCT 幸存者表现出更多与男性衰老相关的症状。
