Ganguan Pendengaran Akibat Pemakaian Kemoterapi Platinum pada Tumor Padat Anak

Abstract

Background. Background Platinum-based chemotherapy cisplatin and carboplatin is widely use in several types of solid tumor. The treatment has side effects including hearing loss. Objectives The aim of this study was to evaluate the prevalence and to identify risk factor of platinum-related hearing loss. Methods A cross-sectional study was performed in Adam Malik Hospital Medan between April and July 2012. Twenty-two subjects, who fulfilled the eligibility criteria, underwent a through otoacoustic emission evaluation. Eleven children had received cisplatin and eleven treated with carboplatin. The median age was 5.7 years. The Median cumulative dose was 390/m² for cisplatin and 615/m² for carboplatin. The association between hearing loss and covariates were assessed using Fisher’s exact test and Pearson Chi-Square. Result Seven of 22 subjects with hearing loss were identified, 5 patients (71%) had cisplatin and 2 patients (29%) had carboplatin. There was no stastically significant difference between carboplatin and cisplatin associated hearing loss (P = 0.361). No influence of sex (P = 0.452) and age (P = 0.212) related hearing loss. A trend for higher cumulative dose of cisplatin >600/m² and carboplatin >1800/m² to be associated with hearing loss (P = 0.022 and P = 0.004, respectively). Conclusion Patients who had higher cumulative dose platinum-based chemotherapy are at risk for developing hearing loss.

Latar belakang. Kemoterapi platinum cisplatin dan carboplatin digunakan secara luas dalam terapi berbagai tumor padat pada anak. Akan tetapi platinum mempunyai efek samping yang merugikan diantaranya gangguan pendengaran Tujuan. Untuk mengetahui prevalensi gangguan pendengaran yang disebabkan kemoterapi platinum serta faktor risiko yang ikut berperan. Metode. Penelitian ini bersifat potong lintang dilaksanakan di Rumah sakit Adam Malik pada bulan April 2012 sampai Juli 2012. Duapuluh dua subjek yang memenuhi kriteria inklusi terdiri dari 11 orang mendapat kemoterapi cisplatin dan 11 orang mendapat carboplatin. Seluruh sampel dilakukan pemeriksan OAE (otoacoustic emission). Hasil. Dari 22 orang subjek, 7 orang diantaranya mengalami gangguan pendengaran 5 (71%) dengan kemoterapi cisplatin dan 2 (29%) dengan terapi carboplatin. Tidak dijumpai perbedaan signifikan antara cisplatin dan carboplatin yang berhubungan dengan gangguan pendengaran (P=0.361). Demikian juga dengan jenis kelamin (P=0.452) dan umur (P=0.212). Sebaliknya dijumpai hubungan antara gangguan pendengaran dengan dosis kumulatif. Cisplatin menimbulkan gangguan pendengaran pada dosis kumulatif diatas 600 mg/m2 (P=0.022) dan carboplatin diatas 1800 mg/m2 (P=0.004) Kesimpulan. Pemakaian kemoterapi platinum tumor padat dengan kumulatif dosis tinggi merupakan faktor risiko untuk mendapatkan gangguan pendengaran.