Berger C C, Bokemeyer C, Schuppert F, Schmoll H J
Division of Haematology/Oncology, Hannover University Medical School, Germany.
Br J Cancer. 1996 May;73(9):1108-14. doi: 10.1038/bjc.1996.213.
Type and extent of endocrinological alterations were studied in long-term disease-free survivors after cisplatin-based chemotherapy for testicular cancer. A total of 63 patients with a median age of 30 (19-53) years, and median follow-up of 42 (16-128) months were included. Elevated serum follicle-stimulating hormone (FSH) levels were found in 63% of patients, 24% showed pathologically elevated luteinising hormone (LH) levels with normal and 10% with subnormal testosterone levels. The degree of gonadotropin elevation was highly significantly correlated with the cumulative platinum (P) dose. Patients treated with platinum-vinblastine-bleomycin regimens showed higher gonadotropin levels than those treated with platinum-etoposide-bleomycin. The adrenal androgen dehydroepiandrosterone (DHEA), pathologically elevated in 68% of patients, was significantly correlated with the cumulative doses of chemotherapy (ctx) used and to the gonadotropin levels. Treatment variables, such as type and dose of cytotoxic agents used, as well as degree of gonadotropin elevation were further correlated with changes in oestron, testosterone and 17 alpha-OH-progesterone levels. Cholesterol levels were elevated in 32% of patients and significant interactions between the steroid hormone levels and cardiovascular risk factors could be shown.
对接受基于顺铂的化疗后的睾丸癌长期无病生存者的内分泌改变类型和程度进行了研究。共纳入63例患者，中位年龄30（19 - 53）岁，中位随访时间42（16 - 128）个月。63%的患者血清促卵泡激素（FSH）水平升高，24%的患者黄体生成素（LH）水平病理性升高，其中睾酮水平正常的占24%，睾酮水平低于正常的占10%。促性腺激素升高程度与累积铂（P）剂量高度显著相关。接受顺铂-长春花碱-博来霉素方案治疗的患者促性腺激素水平高于接受顺铂-依托泊苷-博来霉素治疗的患者。肾上腺雄激素脱氢表雄酮（DHEA）在68%的患者中病理性升高，与所用化疗（ctx）的累积剂量以及促性腺激素水平显著相关。治疗变量，如所用细胞毒性药物的类型和剂量，以及促性腺激素升高程度，与雌酮、睾酮和17α-羟基孕酮水平的变化进一步相关。32%的患者胆固醇水平升高，并且可以显示类固醇激素水平与心血管危险因素之间存在显著相互作用。
