Although the cumulative dose is important, the administration of Cisplatin to young cancer patients also appears to have a notable and adverse effect on the progressive hearing loss associated with Cisplatin use (CIHL). , according to a large multicenter study.

Dr Etan Orgel of Children’s Hospital Los Angeles said: “Cisplatin is a very effective chemotherapy agent that causes permanent hearing loss that is devastating to children who survive cancer. “

“This study shows us how we must change the way we use pharmaceuticals to treat illness and improve children’s quality of life for decades to come,” he told Reuters Health. by email.

In an article in The Lancet Child and Adolescent Health, Dr. Orgel and colleagues observed that most reports of the condition were limited by the small number of patients, small facility group, and uncertainty. Consistency leads to conflicting results.

In an effort to mitigate this problem, the researchers examined data on 1,481 young patients treated with cisplatin at multiple cancer centers across Canada and the United States. Among these patients, 1,275 are under 15 years old and the remaining 206 are older; 96% had an acoustic measurement at their latest follow-up, 3.9 years on average after diagnosis.

Overall, 44% of cases had moderate or severe cisplatin-related hearing loss, and the highest rate (59%) was seen in patients younger than 5 years of age. In addition, more than half of patients with CNS tumors, hepatoblastomas, and neuroblastomas have moderate or severe hearing loss, but in some cases less than a third of patients have hearing loss. when receiving Cisplatin to treat germ cell tumors, osteosarcomas, or other cancers.

After calculating the cumulative Cisplatin dose, the team also found that the higher fractional dose was significantly associated with the risk of CIHL (progressive hearing loss with Cisplatin use). For each increment of 10mg/m2 per day, the adjusted rate was 1.15. For each 50 mg/m2 increment per cycle, the corresponding aOR was 2.16.

In addition, vincristine treatment was also recently identified as a significant risk factor for CIHL (aOR, 3.55).

The team found no difference in progression-free survival or overall survival between patients with moderate or severe CIHL at the end of treatment and those who did not.

“Variations in cisplatin dosage confer the risk of developing CIHL,” they conclude, “and warrant investigation as a potential approach to reducing the treatment burden.”

Translator: Tran Gia Tan

Original link: www.medscape.com/viewarticle/946691

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