Kretschmar C S, Warren M P, Lavally B L, Dyer S, Tarbell N J
Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA.
J Clin Oncol. 1990 Jul;8(7):1191-8. doi: 10.1200/JCO.1990.8.7.1191.
From March 1984 through March 1989 we performed 235 audiometric tests on 39 children with malignant brain tumors who were treated with cisplatin 100 mg/m2 every 3 weeks for three courses and vincristine weekly for 9 weeks followed by cranial irradiation. Twenty-eight of the 39 children had sufficient serial testing for evaluation of ototoxicity secondary to cisplatin. Following the third cisplatin treatment (300 mg/m2 cumulative dose), 20% of the assessable children had hearing loss limited to the high frequencies of 6,000 to 8,000 Hz, 16% had hearing loss beginning at 3,000 to 4,000 Hz, and three children (11%) had loss within the speech frequencies beginning at 1,000 to 2,000 Hz. Eighteen of 19 children (95%) who were evaluated comparatively at a median of 15 months following radiation showed no significant change from preradiation testing. There was no correlation between hearing loss and patient age. We conclude that cisplatin ototoxicity was acceptable and that radiation therapy does not increase the ototoxicity of cisplatin when the drug is given before, instead of following, cranial irradiation.
从1984年3月至1989年3月，我们对39例患有恶性脑肿瘤的儿童进行了235次听力测试。这些儿童接受每3周一次、每次100 mg/m²、共三个疗程的顺铂治疗，以及每周一次、共9周的长春新碱治疗，随后进行颅脑照射。39例儿童中有28例进行了足够的系列测试，以评估顺铂所致的耳毒性。在第三次顺铂治疗后（累积剂量300 mg/m²），20%可评估的儿童出现了局限于6000至8000 Hz高频的听力损失，16%的儿童出现了始于3000至4000 Hz的听力损失，3例儿童（11%）出现了始于1000至2000 Hz的言语频率范围内的听力损失。19例儿童中有18例（95%）在放疗后中位时间15个月时进行了比较评估，结果显示与放疗前测试相比无显著变化。听力损失与患者年龄之间无相关性。我们得出结论，顺铂耳毒性是可以接受的，并且当在颅脑照射之前而非之后给予顺铂时，放射治疗不会增加顺铂的耳毒性。
