Platinum compounds induced nephrotoxicity and ototoxicity in childhood cancers

Objectives: to determine the nephrotoxic and ototoxic effects of chemotherapeutic platinum compounds in children with solid tumors. material and methods: the study was conducted at the department hematology and oncology,the children's hospital and institute of child health,lahore,pakistan from november 2008 to october 2009. all patients with solid tumors admitted were enrolled in which platinum compounds were administered as a part of chemotherapy protocol with baseline serum electrolytes,renal function and audiometric evaluation before and after each cycle of chemotherapy. results: total of 30 patients were included in the study (m:f;1.5:1). there was significant deterioration in glomerular filtration rate (gfr) associated with cumulative doses of cisplatin and carboplatin (p=.01). hypomag-nesaemia (serum magnesium <1.5 mg/dl) was observed in 13.7% of patients with cisplatin and 12.1% of patients with carboplatin therapy. gfr ranged between 22 ml/min/1.73m 2 and 160 ml/min/1.73m 2. gfr decreased significantly with increasing cumulative dose of cisplatin. cisplatin was also significantly associated with more profound hearing loss than carboplatin (p=0.01). conclusions: platinum compounds have profound nephrotoxicity and ototoxicity in the treatment of pediatric solid tumors. carboplatin may be relatively safer than cisplatin in children,however further large scale controlled trials are required.