MENSTRUAL AND HORMONE PATTERNS IN WOMEN TREATED WITH HIGH-DOSE CISPLATIN AND BLEOMYCIN

Menstrual and hormone patterns were investigated in 10 fertile women ( median age 37, range 25-43 years) with locally advanced cervical cance r treated with neoadjuvant chemotherapy (CT). CT consisted of two cycl es of high-dose cisplatin (CDDP, 40 mg/m(2), Days 1 to 4) and bleomyci n (B, 15 mg/m(2), Days 1 and 8) separated by an interval of 21 days. M enstrual patterns before and during CT were recorded. FSH, LH, estradi ol, and progesterone were assayed on the day that treatment was begun, after 2 and 4 days of CDDP administration, and weekly between and aft er the two cycles. Hormone assays during the first week of CT showed n o significant change in hormone levels. After the first course of CT, five patients showed hypergonadotrophic amenorrhea and five patients m aintained menses, two showing ovulatory and three showing follicular p hase hormone patterns. After the second course of CT, one more patient become amenorrheic, and endocrine follow-up showed that two patients maintained hypergonadotrophic amenorrhea, four with hypergonadotrophic amenorrhea had a return of hormone levels to the follicular range of 7-9 weeks after, three maintained follicular phase hormone patterns un til operation, and one ovulated. Gonadal dysfunction should be include d among the side effects of high-dose CDDP and B regimens. (C) 1994 Ac ademic Press, Inc.