Vermorken J B, Kapteijn T S, Hart A A, Pinedo H M
Eur J Cancer Clin Oncol. 1983 Jan;19(1):53-8. doi: 10.1016/0277-5379(83)90398-x.
During and after 233 cycles of cis-diamminedichloroplatinum (II) (CDDP), 197 serial audiograms were obtained in 48 patients and compared with baseline audiograms. Use was made of three dose schedules (20 mg/m2, 25-50 mg/m2 and 70-120 mg/m2), two regimens (single-day or daily for 5 days) and three modes of administration (rapid infusion, 2- or 3-hr infusion, 24-hr infusion). Clinical hearing loss occurred in 12.5% and tinnitus in 25% of all patients. The incidence of audiographic changes (65% overall, 81% bilaterally) increased with increasing cumulative CDDP dose independent of treatment schedule. The incidence was correlated with the daily dose (P = 0.0037) and changes were more severe after single high doses. No difference was found between the single low dose and the daily for 5 days regimen. Rapid infusion of a single high dose was more ototoxic than a 24-hr infusion of the same dose (P = 0.0015). It is concluded that, compared with the single high-dose regimen, the daily low dose for 5 days is preferable in cases where the patient might be cured by a regimen including CDDP.
在顺二氯二氨铂（II）（CDDP）进行233个周期治疗期间及之后，对48例患者进行了197次连续听力图检查，并与基线听力图进行比较。采用了三种剂量方案（20mg/m²、25 - 50mg/m²和70 - 120mg/m²）、两种给药方案（单日给药或连续5天每日给药）以及三种给药方式（快速输注、2或3小时输注、24小时输注）。所有患者中临床听力损失发生率为12.5%，耳鸣发生率为25%。听力图变化的发生率（总体为65%，双侧为81%）随CDDP累积剂量增加而升高，与治疗方案无关。该发生率与每日剂量相关（P = 0.0037），单次高剂量后变化更严重。单次低剂量与连续5天每日给药方案之间未发现差异。单次高剂量快速输注比相同剂量的24小时输注耳毒性更大（P = 0.0015）。结论是，与单次高剂量方案相比，在患者可能通过含CDDP的方案治愈的情况下，连续5天每日低剂量方案更可取。
