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Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats
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Practical grading system for evaluating cisplatin ototoxicity in children.

Kay W Chang1, Nina Chinosornvatana

  • 1Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA. kchang@stanfordmed.org

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
|March 3, 2010
PubMed
Summary

A new ototoxicity grading system with specific audiometric criteria proves more effective than CTCAE for identifying chemotherapy-induced hearing loss and guiding audiology interventions in children.

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Area of Science:

  • Pediatric Oncology
  • Audiology
  • Ototoxicity Research

Background:

  • Chemotherapy agents like cisplatin and carboplatin can cause ototoxicity, leading to hearing loss in children.
  • Accurate grading of ototoxicity is crucial for timely audiology interventions and management.

Purpose of the Study:

  • To validate a novel ototoxicity grading system with defined, frequency-specific audiometric criteria.
  • To compare the new system's clinical utility against the established Common Terminology Criteria for Adverse Events (CTCAE).

Main Methods:

  • Retrospective chart review of 134 children undergoing chemotherapy (cisplatin/carboplatin).
  • Evaluation of pure-tone audiograms using the proposed grading system and CTCAE criteria.
  • Comparison of grades with audiology interventions and clinical parameters.

Main Results:

  • The proposed grading system (Chang grade 2a or higher) predicted the need for audiology intervention.
  • Both systems correlated with recommendations for assistive devices, but the Chang scale was more specific.
  • Factors like cisplatin use, radiation, younger age, and longer treatment duration were associated with more severe hearing loss.

Conclusions:

  • The new grading system offers robust, clinically relevant criteria for assessing chemotherapy-induced hearing loss.
  • It is more sensitive and specific than CTCAE for identifying clinically significant ototoxicity impacting speech, language, and hearing device needs.