Pediyatrik kanser tedavisinde kullanılan sisplatine bağlı ototoksisite nedenleri ve önleyici yaklaşımlar
Yıl 2025,
Cilt: 34 Sayı: 1, 44 - 60, 31.03.2025
Ceren Güneş
,
Ahmet Atila
Öz
İşitme kaybı, tinnitus ve/veya vertigo olarak kendini gösteren ototoksisite platin kemoterapisinin yan etkilerinden birisidir ve koklea içinde reaktif oksijen türlerinin toksik düzeylerde üretilmesiyle ortaya çıkar. Koklear saç hücresi hasarı genellikle doza bağımlı, iki taraflı ve geri döndürülemezdir. İşitme kaybı tedavi sırasında veya tedavi tamamlandıktan yıllar sonra da ortaya çıkabilir. Ototoksisite kalıcıdır ve düzeltilmediği takdirde çocuklarda okul ve kariyer sorunlarına neden olabilir, yaşlılarda ise bilişsel gerilemeyi hızlandırabilir. Otoksisitenin erken tespitine imkan verecek standartlaştırılmış odyolojik izleme protokolleri faydalı olabilir. Çocuklarda ototoksisiteyi önlemek için FDA onaylı tek tedavi sodyum tiyosülfattır. İşitme cihazlarından yararlanamayan ileri derecede işitme kaybı olan çocuklarda koklear implant önemli fayda sağlayabilir.
Kaynakça
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