铂类药物所致实体肿瘤患儿听力损伤  

Acoustic Injury Induced by Platinum in Children with Solid Tumors

作　　者：童楚鸿 白杰 刘晶[1] 赵文[1] 段超[1] 王希思[1] 金眉[1] 马晓莉[1] 苏雁[1] 刘海红[2] TONG Chu-hong;BAI Jie;LIU Jing;ZHAO Wen;DUAN Chao;WANG Xi-si;JIN Mei;MA Xiao-li;SU Yan;LIU Hai-hong

机构地区：[1]国家儿童医学中心/首都医科大学附属北京儿童医院肿瘤内科/儿童肿瘤中心/儿童肿瘤国家临床重点专科/首都医科大学基础-临床联合实验室(儿童肿瘤发病机制与创新药物研究实验室)/儿科重大疾病研究教育部重点实验室,北京100045 [2]国家儿童医学中心/首都医科大学附属北京儿童医院耳鼻咽喉头颈外科/儿童耳鼻咽喉头颈外科疾病北京重点实验室,北京100045

出　　处：《中国听力语言康复科学杂志》2025年第2期140-144,189,共6页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：国家自然科学基金“儿童神经母细胞瘤和肝母细胞瘤防控新策略研究”(82293660/82293665);国家重点研发计划资助“以数据驱动的儿童重大疾病临床用药规范和监管科学研究”(2023YFC2706100/2023YFC2706101)。

摘　　要：目的 探究顺铂、卡铂与儿童实体肿瘤应用铂类药物与发生听力损伤的关系。方法 选取2020年1月~2023年12月于首都医科大学附属北京儿童医院肿瘤内科应用卡铂和/或顺铂的实体肿瘤患儿进行听力监测,运用R语言进行统计学分析。结果 共纳入622例患儿,其中72例(11.6%)发生听力损伤,出现听力损伤的中位时间为开始应用铂类药物的第12个月(1~124个月)。多因素分析显示,顺铂、顺铂合用卡铂、颅脑放疗、清髓剂量卡铂治疗、顺铂同时应用速尿与听力损伤相关(P<0.05)。顺铂累积剂量与听力损伤之间呈非线性关系,当顺铂累积剂量大于680 mg/m^(2)时,顺铂累积剂量每增加100 mg/m^(2),发生听力损伤的风险增加50%。卡铂与听力损伤关系不确定(P>0.05)。结论 顺铂与实体肿瘤患儿听力损伤风险相关,当顺铂累积剂量超过680 mg/m^(2)时,患儿听力损伤的风险明显升高。Objective To explore the relationship between cisplatin and carboplatin and hearing loss caused by platinum drugs in solid tumors in children.Methods From January 2020 to December 2023,children with solid tumors who used carboplatin and/or cisplatin in the Department of Medical Oncology,Beijing Children's Hospital,Capital Medical University,were enrolled for hearing monitoring and statistical analysis using R language.Results 622 children were included in this study,of which 72(11.6%)developed hearing loss,and the median time of hearing loss was 12 months(1-124 months)after the initiation of platinum drugs.Multivariate analysis showed that cisplatin,cisplatin combined with carboplatin,cranial radiotherapy,and cisplatin with furosemide were associated with hearing loss(P<0.05).There was a nonlinear relationship between the cumulative cisplatin dose and hearing loss,with a 50%increase in the risk of hearing loss for every 100 mg/m^(2) increase in cisplatin when the cumulative cisplatin dose was greater than 680 mg/m^(2).The relationship between carboplatin and hearing loss was uncertain(P>0.05).Conclusion Cisplatin is associated with the risk of hearing loss in children with solid tumors.When the cumulative dose of cisplatin exceeds 680 mg/m^(2),the risk of hearing loss is significantly increased.

关 键 词：儿童 实体肿瘤 抗肿瘤治疗 顺铂 卡铂 耳毒性 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]