cisplatin"most ototoxic drug known"-hearing loss when combnd w gemcitabine dosedepndt
Although this paper has to do with lung cancer, when options dwindle and more combos of chemo are suggested, this might be one thing to keep in mind and/or monitor:
NEW YORK (Reuters Health) Mar 10 - The scheduling of cisplatin administration as well as the intensity of dosage appears to be related to ototoxicity in patients receiving the agent along with gemcitabine for treatment of non-small cell lung carcinoma, Dutch researchers report.
In the February 20th issue of the Journal of Clinical Oncology, Dr. Jeany M. Rademaker-Lakhai of the Netherlands Cancer Institute, Amsterdam and colleagues note that cisplatin is the most ototoxic drug known. However, much remains to be established about factors underlying this toxicity.
To investigate further, the researchers studied data on 60 patients who were randomized to cisplatin once a week for 6 weeks or every 2 weeks for 4 weeks.
In all, 328 audiograms covering hearing at baseline and after treatment were analyzed. There was a significant relationship between the dose and dose-intensity and the development of ototoxicity.
Most patients receiving cisplatin at dosages above 60 mg/m showed a decrease in hearing at higher frequencies (4 and 8 kHz).
Moreover, calculated pure tone averages at 1, 2 and 4 kHz, showed a mean hearing loss of 19 dB when cisplatin was administered at doses above 90 mg/m.
Hearing impairment for the same dose intensity was also more severe in patients receiving the agent every 2 weeks compared to those on the 1 week schedule. This, the investigators conclude, "might be explained by the higher total dosages per cycle in the schedules administered every 2 weeks."
J Clin Oncol 2006;24:918-924.
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