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NEJM:硫代硫酸钠可降低顺铂治疗导致的听力损伤风险

2018-06-21 zhangfan MedSci原创

研究人员发现,在顺铂化疗后6小时内接受硫代硫酸钠治疗可显著降低儿童肝母细胞瘤患儿听力损伤风险,且不会影响患儿的生存期

顺铂化疗联合手术是治疗儿童肝母细胞瘤的标准方案,但患儿不可逆听力损伤风险增加。近日研究人员考察了顺铂联合硫代硫酸钠对降低顺铂相关耳毒性的效果。

出生1个月至18岁之间的肝母细胞瘤患者参与研究,患者无转移性疾病,甲胎蛋白水平>100 ng/mL,随机接受顺铂或顺铂联合硫代硫酸钠治疗,术前4个疗程,术后2个疗程。研究的主要终点为3.5岁内的绝对听阈,根据布洛克等级评估听力损伤,次要终点为3年生存率和无事件生存率。

109名患儿参与研究,其中硫代硫酸钠组57人,顺铂组52人,硫代硫酸钠的毒性作用较小。硫代硫酸钠组55名患儿中18人出现1级及以上听力损伤(33%),而顺铂组46人中29人出现1级以上听力损伤(63%,相对风险为0.52)。平均随访52个月,硫代硫酸钠组3年无事件生存率为82%,顺铂组为79%;总生存率为98%和92%。

研究人员发现,在顺铂化疗后6小时内接受硫代硫酸钠治疗可显著降低儿童肝母细胞瘤患儿听力损伤风险,且不会影响患儿的生存期。

原始出处:

Penelope R. Brock et al. Sodium Thiosulfate for Protection from Cisplatin-Induced Hearing Loss. N Engl J Med., June 21 2018.

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createdBy=ca4034296500, createdName=ms3153534357578991, createdTime=Tue Jun 26 05:02:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1642194, encodeId=1c7f16421940c, content=<a href='/topic/show?id=bc99392449e' target=_blank style='color:#2F92EE;'>#听力损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39244, encryptionId=bc99392449e, topicName=听力损伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad0d22872768, createdName=ms1692810954239974, createdTime=Wed May 22 20:02:00 CST 2019, time=2019-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=329754, encodeId=daa2329e54df, content=学习了学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Mon Jun 25 22:24:58 CST 2018, time=2018-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326563, encodeId=5387326563bb, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Sun Jun 24 09:01:23 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1306219, encodeId=7aea130621928, content=<a href='/topic/show?id=aeb639230b7' target=_blank style='color:#2F92EE;'>#听力#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39230, encryptionId=aeb639230b7, topicName=听力)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96d4340, createdName=ysjykql, createdTime=Sat Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397567, encodeId=5818139e567a0, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326058, encodeId=798b32605811, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2ac82155377, createdName=1201e5c5m39暂无昵称, createdTime=Fri Jun 22 08:06:09 CST 2018, time=2018-06-22, status=1, ipAttribution=)]
    2018-07-06 owlhealth

    学习了学习了

    0

  5. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39230, encryptionId=aeb639230b7, topicName=听力)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96d4340, createdName=ysjykql, createdTime=Sat Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397567, encodeId=5818139e567a0, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326058, encodeId=798b32605811, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2ac82155377, createdName=1201e5c5m39暂无昵称, createdTime=Fri Jun 22 08:06:09 CST 2018, time=2018-06-22, status=1, ipAttribution=)]
    2018-06-25 易水河

    学习学习了

    0

  6. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39230, encryptionId=aeb639230b7, topicName=听力)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96d4340, createdName=ysjykql, createdTime=Sat Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397567, encodeId=5818139e567a0, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326058, encodeId=798b32605811, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2ac82155377, createdName=1201e5c5m39暂无昵称, createdTime=Fri Jun 22 08:06:09 CST 2018, time=2018-06-22, status=1, ipAttribution=)]
    2018-06-25 三生有幸9135

    看看

    0

  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39230, encryptionId=aeb639230b7, topicName=听力)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96d4340, createdName=ysjykql, createdTime=Sat Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397567, encodeId=5818139e567a0, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326058, encodeId=798b32605811, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2ac82155377, createdName=1201e5c5m39暂无昵称, createdTime=Fri Jun 22 08:06:09 CST 2018, time=2018-06-22, status=1, ipAttribution=)]
    2018-06-24 三生有幸9135

    学习一下

    0

  8. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39230, encryptionId=aeb639230b7, topicName=听力)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96d4340, createdName=ysjykql, createdTime=Sat Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397567, encodeId=5818139e567a0, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326058, encodeId=798b32605811, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2ac82155377, createdName=1201e5c5m39暂无昵称, createdTime=Fri Jun 22 08:06:09 CST 2018, time=2018-06-22, status=1, ipAttribution=)]
    2018-06-23 ysjykql
  9. [GetPortalCommentsPageByObjectIdResponse(id=1988526, encodeId=bcb51988526b6, content=<a href='/topic/show?id=2e63e355008' target=_blank style='color:#2F92EE;'>#硫代硫酸钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73550, encryptionId=2e63e355008, topicName=硫代硫酸钠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f63175, createdName=nian.wang1982, createdTime=Thu May 30 15:02:00 CST 2019, time=2019-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1737577, encodeId=39451e3757735, content=<a href='/topic/show?id=292f965e5b5' target=_blank style='color:#2F92EE;'>#铂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96575, encryptionId=292f965e5b5, topicName=铂)], attachment=null, authenticateStatus=null, createdAvatar=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39230, encryptionId=aeb639230b7, topicName=听力)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96d4340, createdName=ysjykql, createdTime=Sat Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397567, encodeId=5818139e567a0, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat 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  10. 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Jun 23 05:02:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326058, encodeId=798b32605811, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2ac82155377, createdName=1201e5c5m39暂无昵称, createdTime=Fri Jun 22 08:06:09 CST 2018, time=2018-06-22, status=1, ipAttribution=)]
    2018-06-22 1201e5c5m39暂无昵称

    学习了

    0

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