%0 Journal Article
%T The Potential Use of Melatonin for Preventing Cisplatin Ototoxicity: An Insight for a Clinical Approach
%A Juliana Gusm£¿o de Araujo
%A Andr¨¦ Luiz Lopes Sampaio
%A Alessandra Ramos Venosa
%A Carlos Augusto Costa Pires de Oliveira
%J Advances in Otolaryngology
%D 2014
%R 10.1155/2014/185617
%X Cisplatin, one of the most effective and potent anticancer drugs, is used in the treatment of a wide variety of both pediatric and adult malignancies. However, the chemotherapeutic use of cisplatin is limited by its serious side effects, such as nephrotoxicity and ototoxicity. Ototoxicity produced by cisplatin is usually persistent, depending on the age of the patient, the cumulative number of doses, the number of chemotherapy cycles, the history of noise exposure, and deteriorating renal function. The mechanism of the ototoxicity caused by cisplatin is based on the generation of reactive oxygen species, which interfere with the antioxidant protection of the organ of Corti. Thus, protecting the cochlea with antioxidants ameliorates ototoxicity from cisplatin. In this context, melatonin appears as a therapeutic option for preventing the ototoxic effects of cisplatin, since the research in the last decade has proven its ability to be both a direct free radical scavenger and indirect antioxidant. In this sense, some of the evidence suggesting that melatonin is efficient for combating cisplatin-induced ototoxicity is summarized and discussed in this paper. 1. Introduction Cisplatin is an antineoplastic drug widely used in the treatment of various types of cancer, mainly solid tumors like testicular, ovarian, lung, head, and neck cancers. Nevertheless, its collateral effects, such as nephrotoxicity, neurotoxicity, and ototoxicity, limit its use. Some of these side effects, such as ototoxicity, are dose dependent and this fact prohibits the use of higher doses, which could maximize its antineoplastic activity. While the nephrotoxicity can be diminished or controlled with hydration therapy and diuretics, ototoxicity still remains without an effective treatment. In the last year, many drugs have been studied in an attempt to reduce the cochlear damage induced by cisplatin. Cisplatin-induced ototoxicity is usually manifested by bilateral, progressive, and usually irreversible sensorineural hearing loss, initially occurring in the higher frequencies since cisplatin primarily damages outer hair cells from the basal turn of cochlea and the spiral ganglion neurons [1]. Although ototoxicity caused by cisplatin may occur within hours to days after drug administration, delayed ototoxicity from cisplatin may occur in children [1]. Approximately 23¨C54% of adults and 45% of pediatric patients with head and neck cancer treated with cisplatin develop ototoxicity [2]. There are several risk factors to cisplatin-induced hearing loss, among which are cumulative doses, age,
%U http://www.hindawi.com/journals/aoto/2014/185617/