Vascular aging in long-term survivors of testicular cancer more than 20 years after treatment with cisplatin-based chemotherapy.

Autor: Stelwagen J; Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Lubberts S; Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Steggink LC; Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Steursma G; Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Kruyt LM; Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Donkerbroek JW; Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., van Roon AM; Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., van Gessel AI; Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., van de Zande SC; Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Meijer C; Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Gräfin Zu Eulenburg CH; Department of Epidemiology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Oosting SF; Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Nuver J; Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Walenkamp AME; Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Jan de Jong I; Department of Urology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Lefrandt JD; Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands., Gietema JA; Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands. j.a.gietema@umcg.nl.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2020 Nov; Vol. 123 (11), pp. 1599-1607. Date of Electronic Publication: 2020 Sep 14.
DOI: 10.1038/s41416-020-01049-3
Abstrakt: Background: Late effects of cisplatin-based chemotherapy in testicular cancer survivors (TCS) include cardiovascular morbidity, but little data is available beyond 20 years. The objective was to assess vascular damage in very long-term TCS.
Methods: TCS (treated with chemotherapy or orchiectomy only) and age-matched healthy controls were invited. Study assessment included vascular stiffness with ultrasound measurement of carotid-femoral pulse wave velocity (cf-PWV).
Results: We included 127 TCS consisting of a chemotherapy group (70 patients) and an orchiectomy group (57 patients) along with 70 controls. Median follow-up was 28 years (range: 20-42). The cf-PWV (m/s) was higher in TCS than in controls (geometrical mean 8.05 (SD 1.23) vs. 7.60 (SD 1.21), p = 0.04). The cf-PWV was higher in the chemotherapy group than in the orchiectomy group (geometrical mean 8.39 (SD 1.22) vs. 7.61 (SD 1.21), p < 0.01). In the chemotherapy group cf-PWV increased more rapidly as a function of age compared to controls (regression coefficient b 7.59 × 10 -3 vs. 4.04 × 10 -3 ; p = 0.03).
Conclusion: Very long-term TCS treated with cisplatin-based chemotherapy show increased vascular damage compatible with "accelerated vascular aging" and continue to be at risk for cardiovascular morbidity, thus supporting the need for intensive cardiovascular risk management.
Clinical Trial Registration: The clinical trial registration number is NCT02572934.
Databáze: MEDLINE
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