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Predicting cisplatin ototoxicity in children: the influence of age and the cumulative dose

Y Li1, R B Womer, J H Silber

  • 1The Center for Outcomes Research, The Children's Hospital of Philadelphia, 3535 Market St. Suite 1029. Philadelphia, PA 19104, USA. yuelin@mail.med.upenn.edu

European Journal of Cancer (Oxford, England : 1990)
|November 3, 2004
PubMed

Insights

Younger children and higher cisplatin doses increase the risk of hearing loss in pediatric cancer patients. Age at treatment and cumulative cisplatin dosage are key factors for cisplatin ototoxicity.

Area of Science:

  • Pediatric Oncology
  • Ototoxicity Research
  • Audiology

Background:

  • Cisplatin is a crucial chemotherapy agent used for various pediatric cancers.
  • Ototoxicity, particularly high-frequency hearing loss, is a significant side effect of cisplatin treatment in children.
  • Identifying risk factors is essential for mitigating cisplatin-induced hearing damage.

Purpose of the Study:

  • To identify specific risk factors associated with high-frequency hearing loss in children treated with cisplatin.
  • To analyze the relationship between patient age, cisplatin dosage, and the development of ototoxicity.
  • To provide data for improved monitoring and prevention strategies.

Main Methods:

  • Retrospective analysis of off-treatment pure-tone audiograms from 153 pediatric patients.
  • Patients treated with cisplatin (40-200 mg/m(2)/cycle) for germ cell tumours, hepatoblastoma, neuroblastoma, or osteosarcoma were included.
  • Statistical analysis, including logistic regression, was used to determine risk factors.

Main Results:

  • Significant correlations were found between the risk of bilateral moderate to severe high-frequency hearing loss and age at treatment (P<0.001) and cisplatin dosages (individual and cumulative, P<0.005).
  • Children younger than 5 years had a significantly higher risk (OR=21.17) of cisplatin ototoxicity compared to those older than 15 years.
  • Age at treatment and cumulative cisplatin dose emerged as the most critical predictors of hearing loss.

Conclusions:

  • Age at treatment and cumulative cisplatin dose are the primary risk factors for developing moderate to severe high-frequency hearing loss in children undergoing cisplatin therapy.
  • Younger children are particularly vulnerable to cisplatin-induced ototoxicity.
  • These findings underscore the need for careful monitoring of hearing function in pediatric patients receiving cisplatin, especially younger individuals.

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