Onkológia 3/2020

Late treatment toxicity and quality of life in testicular germ cell tumor survivors

Management of testicular germ-cell cancer (GCT) requires a multidisciplinary approach including surgery, cisplatin-based chemotherapy or abdominal radiotherapy. Today, over 95% of all GCT patients become long-term survivors, and as GCT incidence peaks from 18-40 years, they have a long life expectancy. Late adverse treatment sequelae can lead to higher morbidity in GCT survivors compared with age-matched population ultimately leading to lower quality of life. Among these sequelae are second malignant neoplasms, cardiovascular diseases, pulmonary toxicity, neurotoxicity, ototoxicity, nephrotoxicity, hormonal disturbances, sexual dysfunction, infertility and psycho-social late effects. Evidence shows that increasing doses of cytostatic agents or chemotherapy and ever treatment with radiotherapy results in higher burden of late toxicities. While treatment of GCT cannot be omitted, care-givers must be vigilant to avoid unnecessary overtreatment. The ultimate goal of treating physician should be the cure of GCT with minimal long-term toxicity. Here, we summarize the latest available evidence to provide an updated overview of late toxicity of today’s treatment options in GCT survivors.

Keywords: testicular germ-cell cancer, late adverse treatment, quality of life