Retinal toxicity after high-dose cisplatin therapy.

Wilding, G.; Caruso, Rafael C.; Lawrence, Theodore S.; Ostchega, Yechiam; Ballintine, Elmer J.; Young, Robert C.; Ozols, Robert F.

doi:10.1200/jco.1985.3.12.1683

Cited by 106 publications

(30 citation statements)

References 10 publications

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“…In our case report, we postulate a direct toxic effect of carboplatin, as it was described in the 1970s for cisplatin [5,6,7,8,9,10,11,12,13]. In the case of cisplatin cortical blindness, macula degeneration, retrobulbar neuritis and papilledema were described.…”

Section: Discussionsupporting

confidence: 52%

Carboplatin-Induced Bilateral Papilledema: A Case Report

Fischer¹,

Stuermer

Rodic

et al. 2009

Case Rep Oncol

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We report on a patient with carboplatin-induced bilateral papilledema, as it was described in the 1970s for cisplatin. Loss of visual accuracy up to full blindness, often loss of color vision and scotomas can be seen as a result of cortical blindness, macula degeneration, retrobulbar neuritis and papilledema. These symptoms are mostly unilateral and initially mild, so that more chemotherapy is given before the diagnosis is made. The symptoms are usually reversible within weeks to months after cessation of the platinum treatment. The therapeutic strategy is stopping the platinum treatment. In addition the empiric use of corticosteroids is suggested.

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Section: Discussionsupporting

confidence: 52%

Carboplatin-Induced Bilateral Papilledema: A Case Report

Fischer¹,

Stuermer

Rodic

et al. 2009

Case Rep Oncol

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“…A major dose-limiting toxicity in many studies has been retinal toxicity [15,32]. In this study, one patient developed a painless decrement in visual acuity after her second treatment.…”

Section: Discussionmentioning

confidence: 83%

Intra-arterial cisplatin for the treatment of malignant gliomas

et al. 1989

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Cisplatin (DDP) is a chemotherapeutic agent that has shown efficacy against primary CNS malignancies. Intra-arterial (IA) administration of DDP to patients with brain tumors should produce higher peak levels of drug than intravenous (IV) administration of an identical dose and reduce systemic toxicity. Twelve patients with malignant glioma were entered into the study. All had failed irradiation, 11 had failed IA BCNU. Each patient received IA DDP, 58-100 mg/m2, into the internal carotid artery at four to six week intervals. One of 12 patients had a partial response of 6 months. The remaining 11 patients had progressive disease or severe complications. Toxicity included seizures in four patients, weakness and/or aphasia in four patients, coma in two patients, and visual deterioration in two patients. IA DDP has very limited efficacy in patients with malignant gliomas after failure of nitrosoureas and is associated with an unacceptable level of toxicity. IA DDP may be more effective when used as initial chemotherapy of malignant gliomas.

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“…Among commonly used anticancer agents, retinal toxicity has been reported with high-dose tamoxifen and very high-dose cisplatin (15)(16)(17). For these drugs, dose was the most important determinant of toxicity, with almost no reported toxicity at current recommended doses.…”

Section: Discussionmentioning

confidence: 99%

Characterization and Multiparameter Analysis of Visual Adverse Events in Irofulven Single-Agent Phase I and II Trials

Raymond

Kahatt²,

Rigolet

et al. 2004

Clinical Cancer Research

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Purpose: Irofulven (6-hydroxymethylacylfulvene) is a novel agent, derived from illudin S, with potent apoptotic effects in preclinical models. In the Phase I trial evaluating intermittent weekly schedules, visual symptoms were dose limiting. The aim of this analysis was to better characterize the visual adverse events of irofulven and provide treatment guidelines.Experimental Design: Clinical data from 277 patients entered in single-agent Phase I to II clinical trials who received irofulven on days 1 and 15 every 4 weeks; days 1, 8, and 15 every 4 weeks; or days 1 and 8 every 3 weeks were included in this multiparameter analysis.Results: Overall, 74 patients (27%) experienced visual symptoms. The most frequently reported symptoms were flashing lights (12% of patients), blurred vision (9%), and photosensitivity (8%). Grade 3 toxicity was observed in 12 patients (4%). The incidence and severity of visual events were dose dependent, with no grade 3 visual events occurring at doses <0.50 mg/kg and grade 1 to 2 events in only 12% and 8% of patients, at doses of <0.50 mg/kg and <20 mg/m 2 , respectively. Grade 1 to 2 toxicity was reversible in most patients. Abnormal electroretinogram and abnormal visual fields were noted after irofulven treatment in 24 of 39 patients (62%) and 15 of 26 patients (58%), respectively. All but 1 patient who had electroretinogram assessment received doses >0.50 mg/kg. Clinical examination and visual field assessment were found to be better correlated with symptoms and appear to be more appropriate for surveillance of irofulven retinal symptoms than electroretinograms. Conclusions: On the basis of retained antitumor activity and reversibility of grade 1 and 2 visual symptoms at lower doses, it appears that an irofulven dose of <0.50 mg/kg or <20 mg/m 2 , not to exceed 50 mg in a single dose, given as a 30-minute infusion on days 1 and 8 every 3 weeks or days 1 and 15 every 4 weeks minimizes the frequency and severity of visual symptoms.

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Retinal toxicity after high-dose cisplatin therapy.

Cited by 106 publications

References 10 publications

Carboplatin-Induced Bilateral Papilledema: A Case Report

Carboplatin-Induced Bilateral Papilledema: A Case Report

Intra-arterial cisplatin for the treatment of malignant gliomas

Characterization and Multiparameter Analysis of Visual Adverse Events in Irofulven Single-Agent Phase I and II Trials

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