In 70% of the cases of
malignant neoplasms in pediatric patients antiblast
therapy is used. The administration of
platinum compounds,
Cisplatin (CDDP) or
Carboplatin (
CBDCA), often at high cumulative doses, necessarily implies a certain degree of toxicity which normally takes on secondary significance in the healing of the child. Among the side effects, early and delayed
ototoxicity is well known and, in the child, take on particular aspects. While not abandoning the treatment of the base pathology, the therapeutic findings, increasingly comforting in terms of long-term survival, require more accurate evaluation and overall control of the quality of life of these young patients. Since initial cochlear damage can be reversible, auditory function must be carefully monitored in order to prevent the lesions from becoming permanent, in particular prior to the onset of speech. For this reason a retrospective study was made of a group of 26 children affected by
malignant neoplasms all of whom had undergone a
polychemotherapy protocol with the administration of CDDP in 14 cases and
CBDCA in 12 cases. All these young patients were monitored with conventional audiometry. The presence of different variables (antiblastic
drug administration schedule, course of the disease, general conditions) only permitted evaluation of a single correlation: between auditory function at the end of the treatment (or after a few cycles of
therapy) and the overall dose of CDDP or
CBDCA administered. In 16 cases (62%) typical bilateral perceptive
deafness was detected progressively involving the hyperacute and acute frequencies. The finding of
hearing loss was significantly greater in the patients treated with CDDP (86%) vs. those treated with
CBDCA (33%). Moreover, analysis of the results showed that, within certain limits,
ototoxicity can depend more on individual sensitivity to the
drug than to the total dose administered. The results confirm the well-known
ototoxicity of
platinum compounds, in particular CDDP. As ever improved therapeutic results are achieved in the treatment of
malignant neoplasms in pediatric patients, greater attention can be paid to the quality of life of these young patients after the disease has been healed. Careful monitoring of auditory function can be extremely important in the pursuit this objective; indeed, this makes it possible to adjust antiblast
drug administration, particularly in the later stages of treatment, customizing the treatment schedule to individual patient sensitivity.