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Quality of life in good prognosis patients with metastatic germ cell cancer: A prospective study of the European Organization for Research and Treatment of Cancer Genitourinary Group/Medical Research Council Testicular Cancer Study Group (30941/TE20)

Lookup NU author(s): Dr James Roberts

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Abstract

Purpose: To describe global quality of life (GLQL) in patients with metastatic testicular cancer (TC) treated with four different schedules of bleomycin, etoposide, and cisplatin (BEP) chemotherapy (four v three cycles given over 5 v 3 days). Patients and Methods: Quality-of-life data were prospectively collected in 666 patients with metastatic TC entered into the European Organization for Research and Treatment of Cancer (EORTC) Trial 30941/United Kingdom Medical Research Council Trial TE20, using the EORTC Quality-of-Life Questionnaire C30 and a TC module. Data were analyzed by a mixed effects model and by evaluation of clinically relevant changes at 2 years. Results: The pattern of GLQL changes was similar in the four groups. Two years after chemotherapy, 36% of patients displayed improved GLQL as compared with baseline, whereas GLQL had deteriorated in 13%. At 3 months, patients receiving the 3-day regimen experienced increased gastrointestinal (GI) toxicity more than those receiving the 5-day regimen, with the difference reaching the level of clinical relevance ( greater than or equal to 10-point change) if four cycles were given. The 3-day schedule increased the 2-year risk of tinnitus, with clinical relevance demonstrated after four cycles. Long-term peripheral neuropathy and Raynaud-like phenomena were not associated with the number of cycles or days per cycle. At 2 years, Raynaud-like phenomena, tinnitus, or reduced hearing were reported by 21% to 26% of the patients. Conclusion: Because of the excess of acute GI toxicity and the increased risk of tinnitus after the 3-day regimen, we recommend the 5-day regimen if four cycles of BEP are planned. If only three cycles are to be given, then the 3-day regimen is acceptable, even given the increased risk of nausea/vomiting at 3 months.

Publication metadata

Author(s): Fossa SD, de Wit R, Roberts JT, Wilkinson PM, de Mulder PHM, Mead GM, Cook P, de Prijck L, Stenning S, Aaronson NK, Bottomley A, Collette L

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Oncology

Year: 2003

Volume: 21

Issue: 6

Pages: 1107-1118

ISSN (print): 0732-183X

ISSN (electronic):

Publisher: American Society of Clinical Oncology

URL: http://dx.doi.org/10.1200/JCO.2003.02.075

DOI: 10.1200/JCO.2003.02.075

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