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铂类药物所致小儿癌症患者耳毒性:监测策略、管理干预及未来方向的综合方法

Platinum-Induced Ototoxicity in Pediatric Cancer Patients: A Comprehensive Approach to Monitoring Strategies, Management Interventions, and Future Directions.

作者信息

Ruggiero Antonio, Romano Alberto, Maurizi Palma, Talloa Dario, Fuccillo Fernando, Mastrangelo Stefano, Attinà Giorgio

机构信息

Pediatric Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.

Department of Woman and Child Health and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

出版信息

Children (Basel). 2025 Jul 8;12(7):901. doi: 10.3390/children12070901.

Abstract

Platinum-induced ototoxicity constitutes a significant adverse effect in pediatric oncology, frequently resulting in permanent hearing impairment with profound implications for quality of life, language acquisition, and scholastic performance. This comprehensive review critically evaluates contemporary ototoxicity monitoring practices across various pediatric oncology settings, analyzes current guideline recommendations, and formulates strategies for implementing standardized surveillance protocols. Through examination of recent literature-encompassing retrospective cohort investigations, international consensus recommendations, and functional outcome assessments-we present an integrated analysis of challenges and opportunities in managing chemotherapy-associated hearing loss among childhood cancer survivors. Our findings demonstrate marked heterogeneity in monitoring methodologies, substantial implementation obstacles, and considerable impact on survivors' functional status across multiple domains. Particularly concerning is the persistent absence of an evidence-based consensus regarding the appropriate duration of audiological surveillance for this vulnerable population. We propose a structured framework for comprehensive ototoxicity management emphasizing prompt detection, standardized assessment techniques, and integrated long-term follow-up care to minimize the developmental consequences of platinum-induced hearing impairment. This approach addresses critical gaps in current practice while acknowledging resource limitations across diverse healthcare environments.

摘要

铂类药物引起的耳毒性是儿科肿瘤学中的一个重大不良反应,常常导致永久性听力损害,对生活质量、语言习得和学业成绩产生深远影响。本综述批判性地评估了不同儿科肿瘤学环境下当代耳毒性监测实践,分析了当前指南建议,并制定了实施标准化监测方案的策略。通过审视近期文献,包括回顾性队列研究、国际共识建议和功能结局评估,我们对儿童癌症幸存者化疗相关听力损失管理中的挑战与机遇进行了综合分析。我们的研究结果表明,监测方法存在显著异质性,实施障碍巨大,且对幸存者多个领域的功能状态有相当大的影响。尤其令人担忧的是,对于这一脆弱人群,在听力监测的适当持续时间方面,一直缺乏基于证据的共识。我们提出了一个全面耳毒性管理的结构化框架,强调及时检测、标准化评估技术和综合长期随访护理,以尽量减少铂类药物引起的听力损害对发育的影响。这种方法解决了当前实践中的关键差距,同时承认不同医疗环境中的资源限制。

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Ototoxicity-induced hearing loss and quality of life in survivors of paediatric cancer.儿童癌症幸存者的耳毒性听力损失和生活质量。
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