title: Low incidence of ototoxicity with continuous infusion of cisplatin in the treatment of pediatric germ cell tumors.
abstract: Cisplatin is an important chemotherapeutic agent in the treatment of many pediatric malignancies, but its use is limited in part by ototoxicity. The authors' institution has been administering standard-dose cisplatin by continuous infusion rather than bolus administration in germ cell tumors. The authors retrospectively reviewed 39 patients with germ cell tumors requiring chemotherapy over the past 20 years and recorded data including demographics, cumulative cisplatin dose, degree of ototoxicity (by the Brock grading system), and disease outcome. The median age was 9.4 years and the majority of children (48.7%) had endodermal sinus tumor. Twenty-one children received 400 mg/m of cisplatin or more. One child had evidence of significant ototoxicity at last follow-up (6.64 years after diagnosis). This patient received a total cumulative dose of 500 mg/m of cisplatin. Eighty-two percent of children achieved clinical remission of their disease. The authors conclude that continuous administration of cisplatin is associated with minimal ototoxicity while maintaining good tumoricidal efficacy, and further studies using this regimen are warranted.
authors.affiliation: Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada. abhat0t0@hotmail.com
authors.forename: Abha A
authors.initials: AA
authors.lastname: Gupta
authors.forename: Michael
authors.initials: M
authors.lastname: Capra
authors.forename: Vicky
authors.initials: V
authors.lastname: Papaioannou
authors.forename: Gregg
authors.initials: G
authors.lastname: Hall
authors.forename: Ronnen
authors.initials: R
authors.lastname: Maze
authors.forename: David
authors.initials: D
authors.lastname: Dix
authors.forename: Sheila
authors.initials: S
authors.lastname: Weitzman
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D018240:Endodermal Sinus Tumor / Q000188:drug therapy; D005260:Female; D005440:Fluid Therapy; D005500:Follow-Up Studies; D006207:Half-Life; D006319:Hearing Loss, Sensorineural / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications / Q000188:drug therapy*; D011485:Protein Binding; D012074:Remission Induction; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin