Long-term sequelae after cancer therapy -: Survivorship after treatment for testicular cancer
Long-term sequelae after cancer therapy -: Survivorship after treatment for testicular cancer
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DOI：
10.1080/02841860310023174
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发表时间：
2004-03-01
期刊：
影响因子：
3.1
通讯作者：
Fosså, SD
中科院分区：
文献类型：
--
作者：
Fosså, SD
本文是基于2002年11月在奥斯陆举行的肿瘤学论坛上的一次演讲。睾丸癌幸存者（TCS）的临床研究结果证明了癌症幸存者的长期发病率。最严重的并发症是继发性非生殖细胞恶性肿瘤（相对危险度[RR]：1.4 - 1.6）。放射治疗后，大多数实体恶性肿瘤的诊断范围内或附近的目标体积。联合化疗和放疗会增加这种风险。化疗引起的白血病通常在4 - 7年后报告。经过3或4个周期的顺铂为基础的化疗，15 - 20%的TCS患有周围感觉神经病变，雷诺样现象和/或耳毒性。16%的人观察到性腺功能减退。高胆固醇血症和体重异常会增加心脏并发症的风险。盆腔放疗和顺铂为基础的化疗后出现短暂性少精子症/无精子症，6 - 12个月后恢复。单侧和保留神经的腹膜后淋巴结清扫术后，手术相关的“干射精”风险显著降低，但不孕症仍然是10 - 15%幸存者的长期问题。大多数TCS描述他们的生活质量与年龄匹配的男性一般人群的生活质量相当。并非所有的长期并发症在癌症治愈后都是可以避免的。了解治疗后的长期发病率对于早期识别和治疗晚期并发症至关重要，并使新癌症患者能够获得充分的咨询。
This paper is based on a lecture given during the Oncological Forum, Oslo, in November 2002. Long-term morbidity in cancer survivors is exemplified by results of clinical research in testicular cancer survivors (TCSs). The most serious complication is the development of second, non-germ cell malignancies ( relative risk [RR]: 1.4 - 1.6). After infradiaphragmatic radiotherapy, most solid malignancies are diagnosed within or near the target volume. Combined chemo-radiotherapy increases this risk. Chemotherapy-induced leukaemia is usually reported after 4 - 7 years. After 3 or 4 cycles of cisplatin-based chemotherapy, 15 - 20% of TCSs suffer from peripheral sensory neuropathy, Raynaud-like phenomena and/or ototoxicity. Hypogonadism is observed in 16%. The risk of cardiac complications is increased by hypercholestorolaemia and abnormal body mass. Pelvic radiotherapy and cisplatin-based chemotherapy are followed by transient oligo/azospermia with recovery after 6 - 12 months. The risk of surgery-related 'dry ejaculation' is significantly reduced after unilateral and nerve-sparing retroperitoneal lymph node dissection, but infertility remains a long-term problem in 10 - 15% of survivors. Most TCSs describe their quality of life as comparable with that of the age-matched male general population. Not all long-term complications are avoidable after curative treatment of cancer. Knowledge of post-treatment long-term morbidity is essential for early recognition and treatment of late complications, and enables adequate counselling of new cancer patients.