Intra-arterial cisplatin--associated optic and otic toxicity
K. Maiese, R. W. Walker, R. Gargan and J. D. Victor
Department of Neurology and Neuroscience, Cornell University Medical College, New York, NY 10021.
Over a 22-month period, we investigated optic and otic toxicity
accompanying intra-arterial cisplatin therapy. Baseline and serial
neurologic and ophthalmologic examinations, visual evoked potentials, and
brain-stem auditory evoked potentials were performed in six patients, aged
37 to 53 years. Patients received infraophthalmic intra-arterial cisplatin
(60 mg/m2) every month for three to 10 treatments (mean, six treatments).
Five of the six patients had progressive optic toxicity. In two patients,
the visual evoked potential prolongation preceded acuity loss by at least 4
months. Two patients had evidence of otic toxicity by either brain-stem
auditory evoked potential or click threshold and brain-stem auditory evoked
potential. Intra-arterial cisplatin neurotoxicity may be significant in
patients with already limited survival. Visual evoked potential and
brain-stem auditory evoked potential should be used to monitor patients
receiving potentially neurotoxic therapy.
