CISPLATIN OTOTOXICITY IN CHILDREN - A PRACTICAL GRADING SYSTEM
CISPLATIN OTOTOXICITY IN CHILDREN - A PRACTICAL GRADING SYSTEM
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DOI：
10.1002/mpo.2950190415
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发表时间：
1991-01-01
期刊：
影响因子：
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通讯作者：
PRITCHARD, J
中科院分区：
文献类型：
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作者：
BROCK, PR;BELLMAN, SC;PRITCHARD, J
进行了一项长期随访研究，以评估曾接受“标准剂量”顺铂（60-100 mg/m2/疗程）治疗恶性肿瘤且停止治疗至少2年的儿童的耳毒性。 诊断时的中位年龄为2岁2个月（范围1个月至13.5岁）。 本文在纯音测听听力评估的基础上，提出了一个实用的听力损失0 ~ 4级分级系统。 在一半的儿童中发现了中度至重度高频听力损失（2-4级），其中10名需要适当的助听器。 尽管个体易感性相当大，但随着顺铂累积剂量的增加，发生耳毒性的风险显著增加（P = 0.027）。 连续随访测试，中位时间为顺铂治疗完成后4年，显示这些儿童中没有任何听力恢复。 我们建议在整个顺铂治疗过程中，特别是当剂量达到400 mg/m2及以上时，由听力学顾问医生对幼儿进行仔细监测。 如果发生2级耳毒性，应讨论替代化疗。
A long-term follow-up study was carried out to assess ototoxicity in children who had been treated for a malignant tumour with "standard dose" cisplatin (60-100 mg/m2 per course), and were at least 2 years from stopping treatment. The median age at diagnosis was 2 years 2 months (range 1 month to 13.5 years). On the basis of hearing assessment by pure-tone audiometry, a practical grading system of hearing loss from 0 to 4 is proposed. Moderate to severe high-frequency hearing loss (grade 2-4) was found in half the children and 10 require appropriate hearing aids. The risk of developing ototoxicity increased significantly with the cumulative cisplatin dose (P = 0.027), although there was considerable individual susceptibility. Serial follow-up testing, to a median of 4 years after completion of cisplatin treatment, showed no recovery of hearing in any of these children. We suggest careful monitoring of young children by a consultant audiological physician throughout treatment with cisplatin, particularly when doses of 400 mg/m2 and over have been reached. Alternative chemotherapy should be discussed if grade 2 ototoxicity develops.