EDP-mitotane in children: reassuring evidence of reversible side-effects and neurotoxicity.

Autor: Steenaard RV; Department of Internal Medicine, Máxima MC, Ds. Th. Fliedernerstraat 1, Eindhoven/Veldhoven, 5631 BM , The Netherlands. Rebecca.Steenaard@mmc.nl.; CAPHRI School for Public Health and Primary Care, Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands. Rebecca.Steenaard@mmc.nl., Rutjens M; Department of Internal Medicine, Máxima MC, Ds. Th. Fliedernerstraat 1, Eindhoven/Veldhoven, 5631 BM , The Netherlands., Ettaieb MHT; Department of Internal Medicine, Tergooi, Hilversum/Blaricum, The Netherlands., van Noesel MM; Princes Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.; Division of Cancer and Imaging, University Medical Centre Utrecht, Utrecht, The Netherlands., Haak HR; Department of Internal Medicine, Máxima MC, Ds. Th. Fliedernerstraat 1, Eindhoven/Veldhoven, 5631 BM , The Netherlands.; CAPHRI School for Public Health and Primary Care, Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands.; Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Jazyk: angličtina
Zdroj: Discover. Oncology [Discov Oncol] 2022 Apr 18; Vol. 13 (1), pp. 25. Date of Electronic Publication: 2022 Apr 18.
DOI: 10.1007/s12672-022-00486-1
Abstrakt: Adrenocortical carcinoma affects one in 5 million children each year. Since prognosis for children older than 4 years is limited, clinicians often choose aggressive treatment with etoposide, doxorubicin, cisplatin (EDP) and mitotane after resection. However, little is known about the impact of EDP-mitotane in children. We provide an overview of case-reports and case series listing side-effects and neurotoxicity of EDP-mitotane in children. Fourteen studies were identified describing a range of gastro-intestinal, endocrine, developmental and neuropsychological side-effects. Neurotoxicity included motor- and speech delay, decreased concentration and lower school performance. These side-effects appear to be reversible after mitotane discontinuation. We have added our own experience with a 10 year old girl with advanced adrenocortical carcinoma treated with EDP and 2 years of mitotane after irradical resection. She developed an impactful, but reversible, decrease in cognitive development measured by a standardized neuropsychological assessment before, during and after mitotane therapy. This decrease was mostly measurable in terms of decreased processing speed and concentration and a significant drop in school performance. Combined with fatigue and insecurity, this caused problems in short-term memory and the need to change her school type. In conclusion, EDP-mitotane is associated with several side-effects including neurotoxicity in pediatric cases, all reversible after mitotane discontinuation.
(© 2022. The Author(s).)
Databáze: MEDLINE
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