Neuro- and ototoxicity of high-dose carboplatin treatment in poor prognosis ovarian cancer patients.
BACKGROUND
Hematopoietic toxicity of high-dose carboplatin (HD-CBDCA) chemotherapy can be managed effectively with autologous blood cell support, but no conclusive data are available on its neuro- and ototoxicity.


METHODS
We determined the neuro- and ototoxicity of HD-CBDCA in 10 patients affected by advanced ovarian cancer. HD-CBDCA was delivered as 24-hour continuous infusion or as 5-day schedules. Each patient underwent an extended clinical and instrumental neurological and otological evaluation before, during and after treatment.


RESULTS
After HD-CBDCA only 1 patient had a clinically-evident peripheral neuropathy, while 3 additional patients had only distal paresthesias. Neurophysiological examination evidenced mild, although diffuse, sensory nerve impairment. Motor nerve impairment was also occasionally observed. All the sensory and motor pathological changes had a favorable course during the follow-up period. Ototoxicity was more severe than neurotoxicity and, in one case it was dose-limiting and audiologic impairment tended to remain constant also in the follow-up period.


CONCLUSIONS
HD-CBDCA treatment can be tolerated by most of the patients, but careful monitoring of neuro- and, especially, ototoxicity should be planned.
Cavaletti
G
G
Clinica Neurologica, Istituto di Scienze Biomediche S. Gerardo, Università di Milano, Monza, Italia. guido.cavaletti@unimi.it
Bogliun
G
G
Zincone
A
A
Marzorati
L
L
Melzi
P
P
Frattola
L
L
Marzola
M
M
Bonazzi
C
C
Cantù
M G
MG
Chiari
S
S
Galli
A
A
Bregni
M
M
Gianni
M A
MA
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D009474:Neurons / Q000187:drug effects; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D011379:Prognosis
D000970:Antineoplastic Agents; D016190:Carboplatin