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암환자 및 암생존 환자에서 Cisplatin과 Vinca Alkaloid가 청력 장애에 미치는 부작용 연구

Other Titles
 Adverse Factors and the Role of Cisplatin and Vinca Alkaloids for Hearing Impairment in Childhood Cancer Patients and Survivors 
Authors
 Min Woo Hur  ;  Seung Min Hahn  ;  In Seok Moon  ;  Ju Yeon Lim  ;  Seul Mi Lee  ;  Chuhl Joo Lyu  ;  Jung Woo Han 
Citation
 Clinical Pediatric Hematology-Oncology, Vol.24(2) : 121-129, 2017 
Journal Title
 Clinical Pediatric Hematology-Oncology 
ISSN
 2233-5250 
Issue Date
2017
Keywords
Survivors ; Hearing loss ; Neoplasms ; Cisplatin ; Vinca alkaloids
Abstract
Background: Although combined chemotherapy has increased survival rates among children with cancer, such treatments can induce sensorineural hearing loss. Therefore, we aimed to identify risk factors for hearing impairments in patients with childhood cancer. Methods: Audiograms were obtained from 115 patients with childhood cancer and survivors (age <20 years). Pure tone audiometry (PTA) was performed at octave intervals within the range of 250-8000 Hz. We evaluated clinical risk factors associated with hearing impairments. Hearing loss was evaluated based on the maximal decibel (dB) loss in any frequency for each ear (RAmax or LAmax) and weighted mean dB loss for specific frequencies (RAavg or LAavg). Results: Forty percent of patients (N=46) exhibited hearing loss >20 dB based on the weighted mean value in either ear. Severe hearing impairments were observed in 56% of patients with brain tumors. Although cisplatin or vinca alkaloids were significant risk factors for hearing impairment, the use of both cisplatin and vinca alkaloids exhibited the highest odds ratio for hearing impairment (P<0.001, <0.001 for R/LAmax; P=0.099, 0.039 for R/LAavg). Multivariate analysis revealed that the use of both cisplatin and vinca alkaloids was an independent risk factor for hearing impairment based on RAmax, LAmax, and LAavg (P<0.001, <0.001, 0.039, respectively). Conclusion: Our findings indicate that cisplatin and vinca alkaloids exert an additive effect on the risk of hearing impairment in survivors of childhood cancer. Further prospective studies are thus required to determine the most effective chemotherapeutic regimen for reducing ototoxicity.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161474
DOI
10.15264/cpho.2017.24.2.121
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실)
Yonsei Authors
문인석(Moon, In Seok) ; 유철주(Lyu, Chuhl Joo) ; 임주연(Lim, Ju Yeon) ; 한승민(Hahn, Seung Min) ; 한정우(Han, Jung Woo)
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