OTOTOXICITY OF CARBOPLATIN - COMPARING ANIMAL AND CLINICAL-MODELS AT THE HOSPITAL FOR SICK CHILDREN

Carboplatin was introduced to the paediatric population as an alternat ive chemotherapeutic agent in the management of various malignant neop lasms, including sarcomas of the head and neck, in the hope that it wo uld have fewer side effects than pre-existing agents. While many inves tigators have considered the ototoxicity of this drug only incidentall y, others have presumed it to be of negligible importance. A recent an imal model of its use has demonstrated damage to the inner hair cells of the cochlea, particularly at the basal turn, with a corresponding h igh incidence of hearing loss. Similarly, 11 of 22 patients who receiv ed this agent at the Hospital for Sick Children over the past 2 years demonstrated a sensorineural hearing loss in the 4 to 12 kHz range. Th is complication occurred as early as after the first dose and was gene rally progressively worse with subsequent doses. Consequently, we reco mmend careful audiologic monitoring of children receiving this agent.