Long-Term Neurotoxicity of Chemotherapy in Adolescents and Young Adults Treated for Bone and Soft Tissue SarcomasReportar como inadecuado




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Sarcoma - Volume 2 1998, Issue 2, Pages 97-105



Department of Oncology, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Box 193, Hills Road, Cambridge CB2 2QQ, UK

Department of Clinical Neurophysiology, Middlesex Hospital, University College, London Medical School, London, UK

Department of Oncology, University College London Medical School, London, UK



Copyright 1998 Hindawi Publishing Corporation.
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose.
To study the long-term neurotoxicity of chemotherapy in adolescents and young adults treated for bone and soft tissue sarcomas.

Patients and Methods.
Thirty-six adolescents and young adults median age 17 years were examined following chemotherapy for bone and soft tissue sarcomas.
Twenty-nine 29-36 had received cisplatin median 400 mg-m2, 15-36 ifosfamide median 20 g-m2, and 12-36 vincristine median 16 mg.
Neurotoxicity was assessed at a median of 8 months range, 154 months after completion of chemotherapy by clinical examination, nerve conduction studies, audiograms and autonomic function tests.
The same nerve conduction studies were carried out in 20 normal volunteers to define normal ranges in this age group.

Results.
Sixteen patients 44% had a significant reduction in deep tendon reflexes, and this clinical parameter correlated well with abnormalities detected in nerve conduction studies.
Vibration perception threshold VPT was raised in 20-36 patients 55% and this was the most sensitive single test in the assessment of neuropathy.
There was a significantcorrelation between VPT and cumulative cisplatin dose received in mg-m2 r=0.607, p<0.01.
Ten of 29 patients 35% had abnormal nerve conduction studies with a pattern characteristic of sensory axonal neuropathy.
No patient complained of auditory symptoms, but minor high tone hearing loss was detected by audiograms in 5-28 patients who had received cisplatin.
No patients had symptoms of autonomic neuropathy, but autonomic function tests showed minor abnormalitiesin 4-22 patients tested, and all had received cisplatin.

Conclusions.
This study demonstrates significant, although asymptomatic, long-term neurotoxicity of cisplatin in adolescents and young adults receiving chemotherapy for bone and soft tissue sarcomas.
Follow-up studies are planned to assess whether these neurological deficits improve with time.





Autor: Helena M.
Earl, Sean Connolly, Christos Latoufis, Karen Eagle, Catherine M.
Ash, Clare Fowler, and Robert L.
Souhami


Fuente: https://www.hindawi.com/



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