Al-Khatib Talal, Cohen Natasha, Carret Anne-Sophie, Daniel Sam
Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Canada.
Int J Pediatr Otorhinolaryngol. 2010 Aug;74(8):913-9. doi: 10.1016/j.ijporl.2010.05.011.
To assess the long-term ototoxicity effect of platinum chemotherapy in a series of pediatric patients.
A prospective cohort study.
Patients who received platinum chemotherapy were identified through review of the pharmacy records from 2000 to 2005. Audiograms pre- and post-treatment with cisplatin were noted. The patients were brought back long after treatment for a repeat audiogram and a questionnaire to assess the impact of ototoxicity on their quality of life.
Forty-nine patients received platinum chemotherapy. Patients' exclusion: two had no pre-chemo audiograms, one had retinoblastoma with congenital hearing loss, three were lost to follow up, five deceased, and seven refused participation. The total number of patients included was 31 with long-term follow up total of 21 patients. The follow up period ranged from 1.5 to 6.6 years (median of 3.4 years). Fourty-two percent (13/31) of the patients suffered from otoxicity (3 mild, 3 moderate, 7 severe-profound). Thirty-three (7/21) of audiograms worsened on long-term follow up. Questionnaire revealed 70% subjective hearing loss with 40% requiring hearing aids.
Ototoxicity after platinum chemotherapy can present or worsen years after completion of therapy. Therefore, we recommend long-term follow up.
评估铂类化疗对一系列儿科患者的长期耳毒性影响。
一项前瞻性队列研究。
通过查阅2000年至2005年的药房记录确定接受铂类化疗的患者。记录顺铂治疗前后的听力图。在治疗很久之后让患者回来进行重复听力图检查并填写一份问卷,以评估耳毒性对其生活质量的影响。
49名患者接受了铂类化疗。排除的患者:2名没有化疗前听力图,1名患有视网膜母细胞瘤伴先天性听力损失,3名失访,5名死亡,7名拒绝参与。纳入的患者总数为31名,其中21名进行了长期随访。随访期为1.5至6.6年(中位数为3.4年)。42%(13/31)的患者出现耳毒性(3例轻度,3例中度,7例重度至极重度)。在长期随访中,33%(7/21)的听力图恶化。问卷显示70%有主观听力损失,40%需要助听器。
铂类化疗后的耳毒性可在治疗完成数年之后出现或加重。因此,我们建议进行长期随访。