Whitehorn H, Sibanda M, Lacerda M, Spracklen T, Ramma L, Dalvie S, Ramesar R
S Afr Med J. 2014 Apr;104(4):288-91. doi: 10.7196/samj.7389.
Cisplatin is administered as the first-line treatment of soft-tissue cancers. It has a reported cure rate of up to 85%, but is associated with a high incidence of ototoxicity, characterised by irreversible bilateral hearing loss and affecting 23 - 50% of adults who receive the drug.
To determine the incidence of cisplatin-induced ototoxicity at Groote Schuur Hospital (GSH), Cape Town, South Africa.
retrospective cross-sectional study of cisplatin-receiving cancer patients attending GSH between January 2006 and August 2011.
A total of 377 patients were recorded as receiving cisplatin therapy during the study period. A 300% increase in new cisplatin-receiving patients receiving audiological monitoring was observed between 2006 and 2010. However, only patients with all clinical data as well as baseline and follow-up audiometric analyses were investigated. One hundred and seven such patients were identified, 55.1% of whom developed cisplatin-induced ototoxicity while receiving high-dose (> or = 60 mg/m2) cisplatin treatment. Higher cumulative cisplatin dosages were associated with development of significant hearing loss (p = 0.027). The odds of developing cisplatin-induced hearing loss were elevated for patients with head and neck tumours and lymphoma (p = 0.0465 and p = 0.0563, respectively) and were significantly lower for those with reproductive cancers (p = 0.0371).
Comprehensive audiological monitoring should be available for every patient during cisplatin treatment to minimise the development of disabling hearing loss.
顺铂是软组织癌的一线治疗药物。据报道，其治愈率高达85%，但与高发生率的耳毒性相关，其特征为不可逆的双侧听力丧失，在接受该药物治疗的成年人中发生率为23% - 50%。
确定南非开普敦古特·舒尔医院（GSH）顺铂诱导耳毒性的发生率。
对2006年1月至2011年8月期间在GSH接受顺铂治疗的癌症患者进行回顾性横断面研究。
在研究期间，共有377例患者记录接受了顺铂治疗。2006年至2010年期间，接受听力监测的新顺铂治疗患者增加了300%。然而，仅对具有所有临床数据以及基线和随访听力分析的患者进行了调查。确定了107例此类患者，其中55.1%在接受高剂量（≥60 mg/m²）顺铂治疗时发生了顺铂诱导的耳毒性。更高的顺铂累积剂量与显著听力损失的发生相关（p = 0.027）。头颈部肿瘤和淋巴瘤患者发生顺铂诱导听力损失的几率升高（分别为p = 0.0465和p = 0.0563），而生殖系统癌症患者的几率则显著较低（p = 0.0371）。
在顺铂治疗期间，应为每位患者提供全面的听力监测，以尽量减少致残性听力损失的发生。
