Chemotherapy and endocrine function in lung cancer

To investigate whether cyclic chemotherapy for lung cancer influenced endocrine function, we monitored thyroxine, cortisol, testosterone, sex hormone binding globulin (SHBG), estradiol, FSH, LH, and transcortin every three weeks in 12 male patients. Treatment regimens consisted of cisplatin and etoposide in 9 patients, or vincristine, doxorubicin, and cyclophosphamide in 3 patients. SHBG and FSH level were significantly elevated after 6 to 9 weeks of therapy, whereas the other variables were unchanged. The results suggest that the therapy induces endocrine gonadal dysfunction. The increments in SHBG levels reflect a considerable fall in free testosterone, and may effect alterations in total androgen/estrogen ratios. The mechanism underlying the increased SHBG levels is unknown.