Analysis of Ototoxicity in Young Children Receiving Carboplatin in the Context of Conservative Management of Unilateral or Bilateral Retinoblastoma
Analysis of Ototoxicity in Young Children Receiving Carboplatin in the Context of Conservative Management of Unilateral or Bilateral Retinoblastoma
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DOI：
10.1002/pbc.21898
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发表时间：
2009-05-01
影响因子：
3.2
通讯作者：
Doz, Franicois
中科院分区：
文献类型：
--
作者：
Jehanne, Mathilde;Rouic, Livia Lumbroso-Le;Doz, Franicois
背景。卡铂在视网膜母细胞瘤的保守治疗中发挥着重要作用，但与这些幼儿的耳毒性风险相关，这些幼儿的感觉预后也可能因视力丧失而受到影响。这项回顾性研究分析了在视网膜母细胞瘤儿童保守治疗的背景下卡铂对听力的影响。方法。对 1994 年至 2002 年间在居里研究所接受治疗的 175 名儿童的数据进行了分析。结果。诊断时的中位年龄为 8 个月（0-60 岁）。卡铂与依托泊苷一起给药 3 天（200 mg/m(2)/天）或 5 天（160 mg/m(2)/天），并采用剂量为 100 mg/m(2) 的二极管激光治疗（化疗）。中位（卡铂累积剂量为2,880 mg/m^2）（560-6,160）。通过纯音测听法调查耳毒性，并在治疗前后按Brock分级量表评分。听力评估的中位随访时间为5年（1.8-11）。8名儿童中检测到耳毒性：3名1级、1名2级和2名4级。两名 4 级听力损失的患者需要助听器。两名儿童出现双侧高频听力损失，被认为是继发于卡铂热的，低于布洛克 1 级。卡铂的中位累积剂量为 3,120 mg/m(2)（1,200-5,830），只有一名儿童在治疗期间出现耳毒性。所有其他病例均在卡铂最后一次治疗结束后发现。 3.7 年（0-7.6）。结论：接受卡铂的儿童需要进行长期听力测定随访。2009 年；52：637-643。
Background. Carboplatin plays an important role in the conservative management of retinoblastoma, but is associated with risk of ototoxicity in these young children whose sensory prognosis may be also compromised by their loss of vision. This, retrospective study analyzed the impact of carboplatin on hearing, in the context of conservative management of children with retinoblastoma. Methods. Data for 175 children treated at the Institut Curie between 1994 and 2002 were analyzed. Results. Median age at diagnosis was 8 months 0-60). Carboplatin was administered on 3 days (200 mg/m(2)/day) or 5 days (160 mg/m(2)/day) with etoposide and with diode-laser therapy at the dose of 100 mg/m(2) (chemothermotherapy). Median (cumulative dose of carboplatin was 2,880 mg/m(2) (560-6,160). Ototoxicity was investigated by pure-tone audiometry and scored by Brock's grading scale before and after treatment. The median follow-up of hearing assessment was 5 years (1.8-11). Ototoxicity was detected in 8 children: 3 grade 1, 1 grade 2, and 2 grade 4. The two patients with grade 4 hearing-loss required hearing aid. Two children developed bilateral high frequency hearing-loss, considered to be secondary to carboplatin hot With less than Brock grade 1. Ototoxicity was observed for a median cumulative dose of carboplatin of 3,120 mg/m(2) (1,200-5,830). Only one child developed ototoxicity during treatment. All other cases were discovered after the last close of carboplatin with a median interval of 3.7 years (0-7.6). No other risk factor for ototoxicity was able to account for these lesions. Conclusion. Children receiving carboplatin require long-term audiometric follow-up. Pediatr Blood Cancer 2009;52:637-643. (C) 2009 Wiley-Liss, Inc.