Antineoplastics
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Antineoplastics Ischaemia: incidence study The frequency of cardiovascular complaints and the time of onset and duration of ischaemic events in different vascular regions associated with antineoplastic therapy were assessed in 21 previously untreated men aged 20-60 (mean 30) years with histologically confirmed non- seminomatous germ cell testicular cancer. 10 patients had metastatic disease; of these patients 4 were stage IIC , 1 stage IVL 1, 1 st age IVL2, 1 stage IVL3 and 3 were stage IVCL3 according to Royal Marsden Hospital classification. 11 stage liB patients received adjuvant chemotherapy after orchidectomy and modified lymphadenectomy. There was no ostensible evidence of pre-existing cardiovascular complaints in these patients. All patients received chemotherapy with cisplatin, vinblastine and bleomycin and were evaluated for history of angina pectoris, Raynaud's phenomenon, intermittent cyanosis of the toes, migraine, and/or cerebrovascular accidents. The incidence of acute vascular events was estimated by questionnaire, review of medical records and cold provocation tests (if Raynaud's phenomenon was suspected). Histological specimens from the lung, skin and remaining testis of 3 patients who _died of relapsed disease were also examined. Analysis of medical records showed that 10 of the 21 patients experienced ischaemic events after chemotherapy. One patient had vascular toxicity in 4 vascular beds (coronary, cerebral, digital and toe arteries), 2 had toxicity in 3 vascular beds and 5 had toxicity in 2 vascular regions. Ischaemic events occurred in 9 of 10 patients with metastatic disease vs 1 of 11 adjuvant patients (p < 0.(01). Angina pectoris was recorded in 8 of the 21 patients, occurring at a median of 5-6 weeks after start of chemotherapy. Intervals between anginal attacks ranged from 2-7 days. All routine ECG's were normal in all patients but 2 patients showed supraventricular tachycardia and 1 other patient showed transient T-wave inversion in the leads V1-V4 during anginal attacks. Seven patients experienced transient bilateral Raynaud 's phenomenon and 6 patients had transient ischaemia of the toes. One patient who experienced ischaemic events in all vascular regions examined , complained of migraine for the first time du rin g his fifth course of chemotherapy. 4 REACTIONS· 13 Aug 1988 'We conclude that acute "a.cu/ar Ischaemlc e"ents are frequent after combination chemotherapy with clsplatln, "Inb/astlne and bleomycin and suggest that angina pectoris and/or Raynaud'. phenomenon may occur more often than diagnosed In the.e patlent. _' Stefenelh TM. Ku zmlts R. Ulrich W . Glogar D European Heart Journal 9: 552·556. 1 988 , ... Nausea and vomiting in children: incidence study Fri ck 58 . GuZZI DeIPo E. Keith JA. Davis MS ChemotherapY'assoclated nausea and vomiting In pediatriC oncology patients. Cancer Nursing 1 t · 118- 124. Apr 1988 [43 references] ".. 0157-727/ / 88/ 0813-0004/0$01 .00/ 0 © ADIS Press
Transcript of Antineoplastics
Antineoplastics Ischaemia: incidence study
The frequency of cardiovascular complaints and the time of onset and duration of ischaemic events in different vascular regions associated with antineoplastic therapy were assessed in 21 previously untreated men aged 20-60 (mean 30) years with histologically confirmed nonseminomatous germ cell testicular cancer. 10 patients had metastatic disease; of these patients 4 were stage IIC, 1 stage IVL 1, 1 stage IVL2, 1 stage IVL3 and 3 were stage IVCL3 according to Royal Marsden Hospital classification. 11 stage liB patients received adjuvant chemotherapy after orchidectomy and modified lymphadenectomy. There was no ostensible evidence of pre-existing cardiovascular complaints in these patients.
All patients received chemotherapy with cisplatin, vinblastine and bleomycin and were evaluated for history of angina pectoris, Raynaud 's phenomenon, intermittent cyanosis of the toes, migraine, and/or cerebrovascular accidents. The incidence of acute vascular events was estimated by questionnaire, review of medical records and cold provocation tests (if Raynaud's phenomenon was suspected). Histological specimens from the lung, skin and remaining testis of 3 patients who _died of relapsed disease were also examined. Analysis of medical records showed that 10 of the 21 patients experienced ischaemic events after chemotherapy. One patient had vascular toxicity in 4 vascular beds (coronary, cerebral , digital and toe arteries), 2 had toxicity in 3 vascular beds and 5 had toxicity in 2 vascular regions. Ischaemic events occurred in 9 of 10 patients with metastatic disease vs 1 of 11 adjuvant patients (p < 0.(01). Angina pectoris was recorded in 8 of the 21 patients, occurring at a median of 5-6 weeks after start of chemotherapy. Intervals between anginal attacks ranged from 2-7 days. All routine ECG's were normal in all patients but 2 patients showed supraventricular tachycardia and 1 other patient showed transient T-wave inversion in the leads V1-V4 during anginal attacks. Seven patients experienced transient bilateral Raynaud 's phenomenon and 6 patients had transient ischaemia of the toes. One patient who experienced ischaemic events in all vascular regions examined , complained of migraine for the first time during his fifth course of chemotherapy.
4 REACTIONS· 13 Aug 1988
'We conclude that acute "a.cu/ar Ischaemlc e"ents are frequent after combination chemotherapy with clsplatln, "Inb/astlne and bleomycin and suggest that angina pectoris and/or Raynaud'. phenomenon may occur more often than diagnosed In the.e patlent._'
Stefenelh TM. Kuzmlts R. Ulrich W . Glogar D European Heart Journal 9: 552·556. 1988 , ...
Nausea and vomiting in children: incidence study Frick 58. GuZZI DeIPo E. Keith JA. Davis MS ChemotherapY'assoclated nausea and vomiting In pediatriC oncology patients. Cancer Nursing 1 t · 118-124. Apr 1988 [43 references] "..
0157-727/ / 88/ 0813-0004/0$01 .00/ 0 © ADIS Press
