Erschienen in:
09.03.2017 | Original Article – Clinical Oncology
Retinal toxicity after cisplatin-based chemotherapy in patients with germ cell cancer
verfasst von:
Simon Dulz, Niels H. Asselborn, Klaus-Peter Dieckmann, Cord Matthies, Walter Wagner, Jens Weidmann, Christoph Seidel, Christoph Oing, Lars A. Berger, Winfried Alsdorf, Blanche Mankichian, Christian Meyer, Malte W. Vetterlein, Philipp Gild, Tim A. Ludwig, Armin Soave, Philipp Schriefer, Andreas Becker, Sascha A. Ahyai, Karin Oechsle, Carsten Bokemeyer, Lars Wagenfeld, Margit Fisch, Michael Hartmann, Felix K-H. Chun, Luis A. Kluth
Erschienen in:
Journal of Cancer Research and Clinical Oncology
|
Ausgabe 7/2017
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Abstract
Purpose
Visual impairment represents an infrequent form of cisplatin-induced neurotoxicity; however, visual deterioration has been reported in several studies. To evaluate potential morphological and functional retinal alterations in patients with germ cell cancer (GCC) treated with cisplatin-based chemotherapy (CBC).
Methods
Multi-disciplinary and multi-institutional study design. Examination of 28 eyes of 14 male GCC patients, who had received at least one cycle of CBC. A matched control group of healthy, untreated patients were included in this study. Subjects underwent a retinal nerve fiber thickness (RNFL) measurement, color vision, visual acuity testing, full-field electroretinograms (ff-ERG). To assess a correlation between cumulative cisplatin dose and measured RNFL and ff-ERG Pearson correlation coefficient analysis was performed.
Results
Both study groups (CBC recipients vs. healthy controls) consisted each of 14 participants with a median patient age of 30 years (interquartile range (IQR) 26–37 years). Tumor histology was seminoma in 6 of 14 patients (43%), and non-seminomatous GCC in 8 of 14 patients (57%). Median cumulative cisplatin dosis at examination was 627 mg/m2 (IQR 413–1013 mg/m2). Morphological assessment revealed reduced RNFL in 11 of 14 patients (78.6%). Reduction in RNFL was significantly correlated to the cumulative CBC dose received (rho = + 0.70; p = 0.004). ff-ERG showed significant differences between CBC recipients and the control group in 2 of 5 tested categories (all p values <0.001).
Conclusion
This study represents first evidence of chronic subclinical retinal toxicity due to cisplatin-based chemotherapy in patients with GCC. The reduction of RNFL might become clinically relevant in upcoming age-related chronic degenerative disorders such as glaucoma.