卡铂对接受局部及不可切除神经母细胞瘤治疗的婴儿的长期肾脏和听力毒性：法国小儿肿瘤学会NBL90研究结果
Long-term renal and hearing toxicity of carboplatin in infants treated for localized and unresectable neuroblastoma: results of the SFOP NBL90 study.
作者信息
Bergeron C, Dubourg L, Chastagner P, Mechinaud F, Plouvier E, Desfachelles A S, Dusol F, Pautard B, Edan C, Plantaz D, Froehlich P, Rubie H
机构信息
Centre Léon Bérard, Département de Pédiatrie, 69373 Lyon Cedex, France.
出版信息
Pediatr Blood Cancer. 2005 Jul;45(1):32-6. doi: 10.1002/pbc.20379.
BACKGROUND
A secondary end point of the NBL90 protocol (Rubie H et al. Pediatr Oncol 2001;36:247-250) was the concern in this infant population for possible carboplatin-(CBDCA) induced late side effects including impaired renal and hearing functions.
PROCEDURE
Glomerular filtration rate (GFR), tubular function (TF), pure tone audiometry (PTA), high-frequency, and transient evoked-otoacoustic emission were prospectively assessed in 30 children alive and disease-free 6 years after the end of the treatment.
RESULTS
Median age at diagnosis and at assessment was 4.7 months and 7 years, respectively. Blood pressure was < or =97.5 centile in all children. The mean estimated GFR was 114 +/- 13 ml/min/1.73 m(2) by Schwartz formula [range 87-145]. TF assessment failed to demonstrate any impairment. 29/30 children had grade 0 ototoxicity and all transient evoked otoacoustic emission were normal.
CONCLUSIONS
With a 6-year follow-up the combination of VP16 and carboplatin given at conventional doses is safe on renal and hearing functions in infants with unresectable neuroblastomas treated according to SFOP NB90.
背景
NBL90方案（鲁比·H等人，《儿科肿瘤学》2001年；36：247 - 250）的一个次要终点是关注该婴儿群体中可能由卡铂（CBDCA）引起的晚期副作用，包括肾功能和听力受损。
程序
在治疗结束6年后，对30名存活且无疾病的儿童进行了前瞻性评估，包括肾小球滤过率（GFR）(、)肾小管功能（TF）(、)纯音听力测定（PTA）(、)高频和瞬态诱发耳声发射。
结果
诊断时和评估时的中位年龄分别为4.7个月和7岁。所有儿童的血压均(\leq)第97.5百分位数。根据施瓦茨公式，平均估计GFR为114±13 ml/min/1.73 m²（范围87 - 145）。TF评估未显示任何损害。30名儿童中有29名耳毒性为0级，所有瞬态诱发耳声发射均正常。
结论
经过6年随访，按照SFOP NB90方案治疗的不可切除神经母细胞瘤婴儿，常规剂量的依托泊苷和卡铂联合使用对肾功能和听力是安全的。
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