Determinants of ototoxicity in 451 platinum-treated Dutch survivors of childhood cancer: A DCOG late-effects study

耳毒性 医学 卡铂 置信区间 累积剂量 优势比 儿科 听力图 内科学 顺铂 外科 听力损失 化疗 听力学
作者
Eva Clemens,Andrica de Vries,Saskia F.M. Pluijm,Antoinette am Zehnhoff‐Dinnesen,Wim J. E. Tissing,Jacqueline J. Loonen,Eline van Dulmen‐den Broeder,Dorine Bresters,Birgitta Versluys,Leontien C.M. Kremer,Heleen J. van der Pal,Martine van Grotel,Marry M. van den Heuvel‐Eibrink
出处
期刊:European Journal of Cancer [Elsevier BV]
卷期号:69: 77-85 被引量:76
标识
DOI:10.1016/j.ejca.2016.09.023
摘要

Abstract

Platinum-containing chemotherapeutics are efficacious for a variety of pediatric malignancies, nevertheless these drugs can induce ototoxicity. However, ototoxicity data on large cohorts of childhood cancer survivors (CCSs) who received platinum agents, but not cranial irradiation are scarce. Therefore, we have studied the frequency and determinants of ototoxicity in a cross-sectional multicenter CCS cohort, including the role of co-medication since it has been suggested that these play a role in ototoxicity. We have collected treatment data and audiograms from the medical records of CCS treated in the seven pediatric oncology centres in The Netherlands. Ototoxicity was defined as Münster grade ≥2b (>20 dB at ≥4–8 kHz). Four-hundred-fifty-one CCS who received platinum agents, but not cranial irradiation (median age at diagnosis: 4.9 years, range: 0.01–19 years) were included. The overall frequency of ototoxicity was 42%. Ototoxicity was observed in 45% of the cisplatin-treated CCS, in 17% of the carboplatin-treated CCS and in 75% of the CCS that had received both agents. Multivariate analysis showed that younger age at diagnosis (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.5–0.6 per 5 years increase); higher total cumulative dose cisplatin (OR: 1.2, 95% CI: 1.2–1.5 per 100 mg/m2 increase); and co-treatment with furosemide (OR: 2.3, 95% CI: 1.4–3.9) were associated with ototoxicity. We conclude that treatment with (higher total cumulative dose of) cisplatin, young age and furosemide co-medication independently are associated with an increased risk of ototoxicity in CCS. Future prospective studies are necessary to confirm the additive risk of co-medication on the development of ototoxicity.
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