Article
Prospective evaluation of ototoxicity of platinum derivatives in adult sarcoma patients: A report from the Late Effects Surveillance System
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Published: | March 20, 2006 |
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Background: Platinum derivatives are known for their ototoxicity. While there have been longitudinal studies in children, such examinations have been lacking in adult sarcoma patients.
Aim: To determine the cumulative incidence and dependencies of ototoxic sequelae of platinum derivatives in a large, prospectively monitored, relapse-free adult sarcoma population.
Methods: Since 1998, the Late Effects Surveillance System (LESS) of the German Society for Paediatric Oncology and Haematology (GPOH) prospectively registers late effects in soft tissue-, osteo- and Ewing’s sarcoma patients of all ages treated within the therapy trials EICESS-92/EURO-E.W.I.N.G.-99, CWS-96/CWS-2002P, COSS-96 in Austria, Germany and Switzerland. The follow-up is conducted locally in accordance with the LESS guidelines. Data is reported to the LESS centre for collation and analysis. According to these guidelines, patients treated with platinum derivatives are examined by audiometry once after cessation of antineoplastic therapy and annually thereafter.
Results: There were 95 patients (36.8% female), with an age >21 years at diagnosis, eligible for this analysis, of whom 2 were soft tissue sarcoma and 93 osteosarcoma patients. Median age at diagnosis was 32.3 (IQR 24.9-40.5) years and median follow-up was 24.3 (IQR 10.4-37.3) months. 85 patients received treatment with cisplatinum, 8 additionally received carboplatinum. Two patients received carboplatinum treatment only. Median cumulative doses were 360 (IQR 240-480) mg/m² for cisplatinum and 1800 (IQR 600-3000) mg/m² for carboplatinum. The cumulative incidence of ototoxic late effects was 33.7% in our cohort: 23.2% of patients developed hearing loss, while 10.5% developed tinnitus. Exactly half of the events were reported at cessation of sarcoma treatment, while the rest were reported within the first two years of follow-up.
Conclusion: Ototoxicity due to platinum derivatives was moderate in our cohort. When compared to our previously described cumulative incidence of hearing loss in pediatric patients (51%), it seems to corroborate the previous finding that organ toxicities of antineoplastic therapy are dependent on patient age.
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