Severity of hearing loss after platinum chemotherapy in childhood cancer survivors.

Abstract

BACKGROUND:

Hearing loss is a potential side effect from childhood cancer treatment. We described the severity of hearing loss assessed by audiometry in a representative national cohort of childhood cancer survivors (CCS) and identified clinical risk factors.

PROCEDURE:

We included all CCS from the Swiss Childhood Cancer Registry who were diagnosed ≤18 age and treated with platinum-based chemotherapy between 1990 and 2014. We extracted audiograms, treatment-related information, and demographic data from medical records. Two reviewers independently assessed the severity of hearing loss at latest follow-up using the Münster Ototoxicity Scale. We used ordered logistic regression to identify clinical risk factors for severity of hearing loss.

RESULTS:

We analyzed data from 270 CCS. Median time from cancer diagnosis to last audiogram was 5 years (interquartile range 2.5-8.1 years). We found 53 (20%) CCS with mild, 78 (29%) with moderate, and 75 (28%) with severe hearing loss. Higher severity grades were associated with (a) younger age at cancer diagnosis (odds ratio [OR] 5.4, 95% confidence interval [CI]: 2.5-12.0 for <5 years); (b) treatment in earlier years (OR 4.8, 95% CI: 2.1-11.0 for 1990-1995); (c) higher cumulative cisplatin doses (OR 13.5, 95% CI: 4.7-38.8 for >450 mg/m2 ); (d) concomitant cranial radiation therapy (CRT) (OR 4.4, 95% CI: 2.5-7.8); and (e) hematopoietic stem cell transplantation (HSCT) (OR 2.7, 95% CI: 1.0-7.2).

CONCLUSION:

Three of four CCS treated with platinum-based chemotherapy experienced some degree of hearing loss. We recommend closely monitoring patient's hearing function if treated at a young age with high cumulative cisplatin doses, and concomitant CRT as part of long-term care.

• Authors: Sven Strebel, Luzius Mader, Tomáš Sláma, Nicolas Waespe, Annette Weiss, Ross Parfitt, Antoinette Am Zehnhoff-Dinnesen, Martin Kompis, Nicolas X von der Weid, Marc Ansari, Claudia E Kuehni
• Journal: Pediatric blood & cancer (Pediatr Blood Cancer) Vol. 69 Issue 9 Pg. e29755 (09 2022) ISSN: 1545-5017 [Electronic] United States
• PMID: 35723448 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2022 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.

Chemical References

• Antineoplastic Agents
• Platinum
• Carboplatin
• Cisplatin

Topics

• Antineoplastic Agents (adverse effects)
• Cancer Survivors
• Carboplatin
• Child
• Cisplatin
• Hearing Loss (chemically induced, epidemiology)
• Humans
• Neoplasms (therapy)
• Platinum (therapeutic use)