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Background: Cochleotoxicity following the treatment with platinum-based chemotherapy is well documented. The potential for vestibulotoxicity is still unclear. This scoping review examined the extent of current research literature, summarized research findings and identified research gaps regarding vestibular-related adverse effects associated with platinum-based chemotherapy in survivors of cancer. Methods: Inclusion criteria followed the PICO principles: Participants, adult, and pediatric cancer patients of any cancer type; Intervention, platinum-based chemotherapy (such as cisplatin, carboplatin, and oxaliplatin); Control, none or any; Outcomes, vestibular-related adverse effects. English language articles published since 1978 were retrieved. Seventy-five eligible studies were identified from a systematic literature search, and relevant data were charted, collated, and summarized. Results: Testing for vestibulotoxicity predominately featured functional evaluation of the horizontal semicircular canal using the caloric and rotational tests. The rate of abnormal vestibular function test results after chemotherapy administration varied from 0 to 50%. The results of objective testing did not always correspond to patient symptoms. There is tentative support for patients with pre-existing loss of vestibular function to be more likely to experience vestibular toxicity after dosing with cisplatin. Conclusions: A number of studies reported significant evidence of vestibular toxicities associated with platinum-based chemotherapy, especially cisplatin. This scoping review emphasizes that vestibular toxicity needs more attention and comprehensive evaluation. Specifically, studies that analyse cumulative dose of platinum-based chemotherapy, affected sites of lesion in vestibular end organs, and the correlation and temporal patterns of cochlear and vestibular toxicity are needed.
RESUMO
INTRODUCTION: Magnetic resonance imaging (MRI) has been increasingly utilized to screen and manage breast care. As the literature demonstrating its benefit expands, so do the potential clinical indications. However, routine review of the literature is merited to re-evaluate the appropriate and cost-effective use of MRI and guide clinicians in the areas of controversy. METHODS: A literature review was performed to evaluate the current evidence for the use of MRI. RESULTS: Evidence supports MRI screening for genetic mutation carriers and for those with an equivalent lifetime risk (>50%). Regarding staging and management, MRI is indicated for monitoring tumour response to neoadjuvant therapy. MRI should also be considered for patients with invasive lobular carcinoma, mammographically occult breast cancer and Paget's disease. DISCUSSION: Though MRI is limited by moderate specificity and high cost, it can be a valuable, sensitive and cost-effective tool with thoughtful and judicious patient selection.