Adverse reactions include nephrotoxicity, sensory neuropathy, ototoxicity, myelosuppression, infertility, Raynaud’s phenomenon.
Long-term testicular cancer survivors of cisplatinum based chemotherapy associated with hypercholesterolemia, obesity, hypothalamic-pituitary-gonadal axis dysfunction, hyperinsulinemia, metabolic syndrome and cardiovascular disease.
Long-term toxicities following cisplatin-based chemotherapy include cardiovascular disease, pulmonary dysfunction, secondary neoplasms, years after treatment have been discontinued.
Peripheral paresthesias, Raynaud’s phenomenon, hearing impairment, and tinnitus have a prevalence of 30-40% in long-term survivors.
1.7 fold increase in risk of cardiovascular disease in 2707 testicular cancer patients associated with cisplatinum based chemotherapy (Belt-Dusebout).
Adverse reactions include nephrotoxicity, sensory neuropathy, ototoxicity, myelosuppression, infertility, Raynaud’s phenomenon.
Cisplatin-induced ototoxicity is permanent and progressive.
Sodium thiosulfate can be used to prevent cisplatin-induced ototoxicity in children and adolescents with cancer.
Long-term testicular cancer survivors of cisplatinum based chemotherapy associated with hypercholesterolemia, obesity, hypothalamic-pituitary-gonadal axis dysfunction, hyperinsulinemia, metabolic syndrome and cardiovascular disease.
May be associated with sustained endothelial injury.
Remains detectable in the plasma of testicular cancer survivors up to 20 years after administration (Gietema).
Cisplatinin in children causes measureable hearing loss in 25-90% of children (Knight KRG).
Ototoxicity results from production of reactive oxygen species within the cochlea.
Causes irreversible free radical related apoptosis of cochlea outer hair cells, spiral ganglion cells and the stria vascularis (Rybal LP).
Cisplatin causes hearing loss, predominantly in the high frequency range, and tinnitus by damaging the outer hair cells of the cochlea.
Risk factors for hearing loss in children include: preexisting hearing loss, young age, cumulative cisplatin dose, dose schedule, coexisting renal impairment and prior radiation, especially if the cochlea is in the RT field.
Hearing loss is greatest in young children, especially below age 5 years: 5 year olds have a 20 fold risk than a 20 year old who receives the same dose of cisplatin.
Has its greatest effect on high frequency ranges, the same ranges young children depend on for acquiring language and social skills.
DNA repair capability is a major determinant of resistance to cisplatin, particularly the excision repair cross-complementation group 1 (ERCC1) protein with an essential role in nucleotide excision repair.