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Ototoxicity in children receiving platinum chemotherapy: underestimating a commonly occurring toxicity that may

Kristin R Gilmer Knight1, Dale F Kraemer, Edward A Neuwelt

  • 1Department of Neurology, Neurosurgery, and Pediatric Audiology, Oregon Health and Science University, Portland 97201, USA.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
|November 30, 2005
PubMed

Insights

Platinum-based chemotherapy causes hearing loss in 61% of pediatric patients. This ototoxicity, especially in younger children, impacts speech and academic development, necessitating better toxicity reporting.

Area of Science:

  • Pediatric Oncology
  • Audiology
  • Clinical Toxicology

Background:

  • Platinum-based chemotherapy is a cornerstone in treating various pediatric cancers.
  • Ototoxicity is a significant concern, potentially impacting long-term quality of life.
  • Current methods for reporting chemotherapy-induced ototoxicity may underestimate its prevalence and severity in children.

Purpose of the Study:

  • To determine the incidence and severity of ototoxicity in pediatric patients receiving platinum-based chemotherapy.
  • To analyze the time course of hearing loss following chemotherapy treatment.
  • To evaluate the influence of specific cancer types and patient characteristics on ototoxicity.

Main Methods:

  • Serial audiologic evaluations were performed on 67 pediatric patients (8 months to 23 years).
  • Hearing loss was assessed using American Speech-Language-Hearing Association (ASHA) criteria.
  • Data were analyzed to identify time to hearing loss and factors influencing ototoxicity.

Main Results:

  • Ototoxicity, defined as bilateral hearing decrease, occurred in 61% of patients, with a median onset of 135 days.
  • Higher incidence and severity of hearing loss were observed in children treated for medulloblastoma, osteosarcoma, and neuroblastoma.
  • The National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) showed inadequate agreement with ASHA criteria for reporting ototoxicity.

Conclusions:

  • Standard toxicity reporting (CTCAE) under-reports ototoxicity and minimizes the impact of hearing loss in pediatric cancer patients.
  • Improved survival rates highlight the importance of addressing hearing loss, particularly high-frequency deficits.
  • The long-term effects on academic achievement and speech development are critical considerations, especially for children under 5 years old.
Abstract

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