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
Centre Léon Bérard, Département de Pédiatrie, 69373 Lyon Cedex, France.
Pediatr Blood Cancer. 2005 Jul;45(1):32-6. doi: 10.1002/pbc.20379.
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.
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.
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.
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.
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。
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。
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。
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。
