Laurell G, Jungnelius U
Department of Audiology, Karolinska Hospital, Stockholm, Sweden.
Laryngoscope. 1990 Jul;100(7):724-34. doi: 10.1288/00005537-199007000-00008.
Fifty-four patients with metastatic cancer were followed audiometrically during high-dose (100-120 mg/m2) cisplatin chemotherapy. Eighty-one percent of the patients showed significant changes in air-conduction hearing thresholds after completion of therapy. Thirteen percent sustained a significant hearing handicap. An interindividual variation was found, ranging from severe hearing loss after the first course to unaffected hearing after three courses. The ototoxic effect was not increased by pre-existing hearing loss, but was slightly increased by age. The risk was determined more by the amount of the single dose than by the cumulative dose. The further ototoxic effect could not be predicted on the basis of the audiogram after the first course. Peak plasma concentration of platinum was measured in eight patients, and no ototoxic changes were noted below a concentration of 1 microgram/L.
54例转移性癌症患者在接受大剂量（100 - 120mg/m²）顺铂化疗期间接受了听力测定。81%的患者在治疗结束后气导听力阈值出现显著变化。13%的患者出现了明显的听力障碍。发现个体间存在差异，从第一疗程后严重听力损失到三个疗程后听力未受影响。既往存在的听力损失并未增加耳毒性作用，但年龄略有增加耳毒性作用。风险更多地取决于单次剂量而非累积剂量。根据第一疗程后的听力图无法预测进一步的耳毒性作用。对8例患者测量了血浆铂的峰值浓度，在浓度低于1微克/升时未观察到耳毒性变化。
