McDonald Megan E, Mattson Jordan, Hill Emily
Division of Gynecologic Oncology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
Department of Obstetrics and Gynecology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
Gynecol Oncol Rep. 2017 Mar 21;20:103-104. doi: 10.1016/j.gore.2017.03.011. eCollection 2017 May.
Few advances in the treatment of advanced epithelial ovarian cancer have improved patient overall survival. However, the incorporation of intraperitoneal administration of platinum based chemotherapy to standard treatment was one such advancement. It is understood that the intraperitoneal regimen is associated with increased toxicity when compared to intravenous administration alone; however, information regarding the specific risk of ototoxicity is lacking in the literature. We report a case of almost complete sensorineural hearing loss after one cycle of intraperitoneal cisplatin. Three days after receiving an intravenous 24 h paclitaxel at 135 mg/m and subsequent intraperitoneal infusion of cisplatin at 75 mg/m, the patient presented with profound bilateral sensorineural hearing loss. The patient experienced no recovery of hearing despite an aggressive systemic steroid taper and change in chemotherapy regimen to alternative agents. She is currently under consideration for cochlear device implantation. Generally, cisplatin related ototoxicity during treatment of epithelial ovarian cancer is gradual, limited to high-frequency ranges and dose-related; however, the toxicity with only one standard dose can be profound and irreversible. This risk should be addressed when counseling patients prior to initiation of treatment.
晚期上皮性卵巢癌治疗方面的进展很少能改善患者的总体生存率。然而,将基于铂的化疗腹腔内给药纳入标准治疗是其中一项进展。据了解,与单纯静脉给药相比,腹腔内给药方案的毒性增加;然而,文献中缺乏关于耳毒性具体风险的信息。我们报告一例腹腔内顺铂治疗一个周期后几乎完全性感音神经性听力丧失的病例。在接受135mg/m²静脉输注24小时紫杉醇及随后75mg/m²腹腔内输注顺铂三天后,患者出现双侧严重感音神经性听力丧失。尽管积极进行全身性类固醇减量并将化疗方案改为替代药物,但患者听力未恢复。她目前正在考虑植入人工耳蜗装置。一般来说,上皮性卵巢癌治疗期间顺铂相关耳毒性是渐进性的,局限于高频范围且与剂量相关;然而,仅一个标准剂量的毒性也可能严重且不可逆。在治疗开始前为患者提供咨询时应提及这种风险。