Dean Jennifer B, Hayashi Susan S, Albert Catherine M, King Allison A, Karzon Roanne, Hayashi Robert J
Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St Louis Children's Hospital, St Louis, MO, USA.
J Pediatr Hematol Oncol. 2008 Feb;30(2):130-4. doi: 10.1097/MPH.0b013e31815d1d83.
Carboplatin is a well-established chemotherapeutic agent used to treat a variety of pediatric malignancies. Platinum analogues such as cisplatin are known to be ototoxic, but little is known regarding the ototoxicity of carboplatin. We performed a single institution retrospective chart review of pediatric oncology patients who received platinum-containing regimens from 1993 to 2002. Ninety-nine patients with sufficient medical and audiologic data were identified. Significant hearing loss was defined as a Brock grade 1 or higher. The incidence was compared among 3 treatment groups (carboplatin only, carboplatin and cisplatin, and cisplatin only). Significant hearing loss in patients receiving carboplatin only was rare, observed in only 1/25 (4%) of patients. In contrast, 19/27 (70%) of patients receiving carboplatin and cisplatin possessed significant hearing loss, as did 27/47 (57%) of those patients receiving cisplatin only P<0.001. The difference in hearing loss could not be explained by different cumulative exposures of the platinum agents. Carboplatin, when used without cisplatin, is rarely associated with severe hearing loss, even at high cumulative doses.
卡铂是一种成熟的化疗药物，用于治疗多种儿童恶性肿瘤。已知顺铂等铂类类似物具有耳毒性，但关于卡铂的耳毒性知之甚少。我们对1993年至2002年接受含铂方案治疗的儿科肿瘤患者进行了单机构回顾性病历审查。确定了99例有足够医学和听力数据的患者。严重听力损失定义为布罗克1级或更高。在3个治疗组（仅卡铂、卡铂和顺铂、仅顺铂）之间比较发病率。仅接受卡铂治疗的患者中严重听力损失很少见，仅在1/25（4%）的患者中观察到。相比之下，接受卡铂和顺铂治疗的患者中有19/27（70%）存在严重听力损失，仅接受顺铂治疗的患者中有27/47（57%）存在严重听力损失，P<0.001。听力损失的差异无法用铂类药物的不同累积暴露量来解释。卡铂在不与顺铂联合使用时，即使在高累积剂量下，也很少与严重听力损失相关。
