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Nebenwirkungen der Polychemotherapie bei metastasierten Hodentumoren

Side-effects of polychemotherapy in metastatic testicular neoplasms

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Summary

25 Patients with metastatic non-seminomatous testicular neoplasms were treated by surgery and cytostatic therapy using a combination consisting of Velban, Bleomycin, Cis-Platinum and/or Ifosfamid. In 22 patients this procedure induced a persistant complete remission with a mean observation time of 23 months. 2 patients died because of post-surgical complications after a second-look-lymphadenectomy. They suffered from rapidly progressive tumor disease. One patient died in a septicemia during chemotherapy.

Our experience is that morbidity of an effective chemotherapy should not be underestimated. Transient bone marrow suppression, anorexia, alopecia and hyperpigmentation are unavoidable. However, severe vomiting, disturbed electrolyte metabolism, hemorrhagic cystitis, anemia and septicemia can well be managed by respective supportive care. Septicemia, for instance, may be treated with appropriate antibiotics without inducing tubular necrosis. Supportive measures also will avoid severe chronic defects of ear and kidney function.

Zusammenfassung

25 Patienten mit metastasierten, nicht-seminomatösen Hodentumoren wurden operiert und zytostatisch mit einer Kombination aus Velbe, Bleomycin, Cis-Platin und/oder Ifosfamid behandelt. In 22 Fällen konnte eine anhaltende Vollremission bei einer mittleren Beobachtungszeit von 23 Monaten erreicht werden. 2 Patienten verstarben durch einen rasch auftretenden Tumorprogreß an postoperativen Komplikationen nach Second-look-LA. Ein Patient erlag nach Chemotherapie einem septischen Schock.

Die Morbidität dieser effektiven Chemotherapie darf nicht unterschätzt werden. Passagere Panmyelophtise, Anorexie, Alopezie und Hyperpigmentationen sind unvermeidbar. Schweres Erbrechen, Elektrolytentgleisung, hämorrhagische Cystitis, Anämie, Septikämien lassen sich durch supportive Maßnahmen reduzieren. Auftretende Septikämien sind durch eine geeignete Antibiotika-Kombination ohne zusätzlichen Tubulusschaden zu beherrschen. Schwerwiegende Dauerschäden insbesondere an Innenohr und Niere können vermieden werden.

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Hartlapp, J.H., Jaeger, N., Fischer, P. et al. Nebenwirkungen der Polychemotherapie bei metastasierten Hodentumoren. Klin Wochenschr 60, 257–261 (1982). https://doi.org/10.1007/BF01728345

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Key words

  • Adverse effects
  • Drug therapy
  • Testicular neoplasms
  • Critical care

Schlüsselwörter

  • Hodentumoren
  • Polychemotherapie
  • Nebenwirkungen
  • supportive Maßnahmen