Originally published as JCO Early Release 10.1200/JCO.2005.01.4092 on November 21 2005

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Acute Chemotherapy-Induced Cardiovascular Changes in Patients With Testicular Cancer

From the Departments of Medical Oncology, Vascular Medicine, Hematology, Cardiology, and Surgical Oncology, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands

Address reprint requests to J.A. Gietema, MD, PhD, Department of Medical Oncology, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; e-mail: j.a.gietema{at}int.umcg.nl

PURPOSE: After cisplatin- and bleomycin-containing chemotherapy for testicular cancer, part of the patient population will develop acute or long-term cardiovascular toxicity. It is largely unknown whether standard tests can be used to assess chemotherapy-induced cardiovascular changes.

PATIENTS AND METHODS: In 65 testicular cancer patients (median age, 27 years; range, 18 to 48 years), we measured the following cardiovascular parameters before and within 10 weeks after completion of cisplatin-based chemotherapy: platelet numbers, plasma levels of hemostatic and fibrinolytic factors, 24-hour ambulatory blood pressure, baroreflex sensitivity, intima-media thickness of the common carotid artery, and flow-mediated vasodilation of the brachial artery.

RESULTS: Compared with prechemotherapy values, the intima-media thickness of the carotid artery and plasma von Willebrand factor levels increased significantly after treatment. Platelet numbers and plasma levels of other hemostatic and fibrinolytic factors did not appear to change significantly. Blood pressure decreased significantly, but flow-mediated vasodilation and baroreflex sensitivity did not change.

CONCLUSION: In testicular cancer patients treated with cisplatin-based chemotherapy, we found an increase in plasma von Willebrand factor levels and in the intima-media thickness of the carotid artery. These changes may indicate chemotherapy-induced vascular damage and be of prognostic significance for the development of cardiovascular complications in the long term.

Supported by Grant No. RUG2000-2177 from the Dutch Cancer Society.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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