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三级肿瘤中心儿科肿瘤患者顺铂和卡铂耳毒性的发生率及危险因素

The Incidence and Risk Factors of Cisplatin and Carboplatin Ototoxicity in Pediatric Oncology Patients at Tertiary Oncology Center.

作者信息

Attar Meshari, Alqarni Mohammed S, Alsinnari Yaser M, Bukhari Ziad M, Alshegifi Hussein, Alzhrani Abdulrahman, Alshaikh Khalid, Alsubaie Haya, Muqat Mahmoud, Alhakami Hadi, Algarni Mohammed

机构信息

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.

King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.

出版信息

Indian J Surg Oncol. 2022 Dec;13(4):925-930. doi: 10.1007/s13193-022-01579-7. Epub 2022 Jul 29.

Abstract

Pediatric cancers are relatively rare diseases when considering all types of cancer. Platinum-based chemotherapeutic agents are potent agents against a variety of pediatric malignancies. An important adverse effect of platinum-based agents is the occurrence of hearing loss. This hearing loss can pose a challenge to detect especially if the child is in his early of life. It will also significantly affect the child development of social, pedagogical, and personal dimensions. It is integral to identify incidence of platinum-based ototoxicity and risk factors that increase the likelihood of developing hearing loss in cancer children. We performed a retrospective chart review of 123 pediatric patients who had completed cisplatin and carboplatin therapy for a variety of malignancies. Patients were diagnosed at Princess Nourah Oncology Centre between January 2011 and December 2016, were less than 14 years old at diagnosis. Audiograms were scored using the International Society of Pediatric Oncology (SIOP) Boston Scale (0-4), a validated grading system for cisplatin-related hearing loss. Ototoxicity was reported in 16 patients out of 123 with a rate of 13%. The incidence of ototoxicity was highest in CNS tumors such as medulloblastoma (37.5%) and optic glioma (25%). Males were at greater risk for developing hearing loss than females. Cumulative cisplatin dose and addition radiation therapy were also identified as risk factors for development of ototoxicity ( = 0.008). Nature and location of cancer, gender, cumulative dose, and addition of radiation therapy are important clinical biomarkers of cisplatin ototoxicity.

摘要

考虑到所有类型的癌症,儿童癌症是相对罕见的疾病。铂类化疗药物是针对多种儿童恶性肿瘤的有效药物。铂类药物的一个重要副作用是听力丧失。这种听力丧失尤其在儿童早期很难被察觉。它还会显著影响儿童在社交、教育和个人层面的发展。确定铂类耳毒性的发生率以及增加癌症患儿发生听力丧失可能性的风险因素至关重要。我们对123例因各种恶性肿瘤完成顺铂和卡铂治疗的儿科患者进行了回顾性病历审查。患者于2011年1月至2016年12月在努拉公主肿瘤中心确诊,确诊时年龄小于14岁。听力图采用国际儿科肿瘤学会(SIOP)波士顿量表(0 - 4)评分,这是一种针对顺铂相关听力丧失的有效分级系统。123例患者中有16例报告了耳毒性,发生率为13%。耳毒性发生率在中枢神经系统肿瘤如髓母细胞瘤(37.5%)和视神经胶质瘤(25%)中最高。男性比女性发生听力丧失的风险更高。顺铂累积剂量和加用放射治疗也被确定为发生耳毒性的风险因素(P = 0.008)。癌症的性质和部位、性别、累积剂量以及加用放射治疗是顺铂耳毒性的重要临床生物标志物。

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