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Updated: May 7, 2026
Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
Published on: March 16, 2018
Cisplatin-induced hearing loss: the need for a long-term evaluating system
Naoko Yasui1, Nodoka Adachi, Motohiro Kato
1*Division of Pediatric Oncology, National Cancer Center Hospital, Tsukiji, Chuo-ku Departments of ‡Hematology/Oncology †Otolaryngology, Saitama Children's Medical Center, Saitama §Department of Speech, Language and Hearing Therapy, Faculty of Health Sciences, Mejiro University Clinic, Tokyo, Japan.
Insights
Pediatric cancer patients treated with cisplatin experienced hearing loss, even at lower doses. Regular hearing evaluations are recommended for all children receiving cisplatin therapy to monitor for ototoxicity.
Area of Science:
- Pediatric Oncology
- Ototoxicology
- Audiology
Background:
- Cisplatin is a vital chemotherapy for pediatric cancers but can cause ototoxicity.
- Hearing loss is a significant concern for children undergoing cisplatin-based treatments.
Purpose of the Study:
- To investigate the frequency, severity, and clinical progression of cisplatin-induced hearing loss in Japanese pediatric patients.
- To identify potential risk factors associated with ototoxicity in this population.
Main Methods:
- Audiologic evaluations were performed on 55 children treated with cisplatin-based multimodal therapy between 1983 and 2012.
- Data analysis focused on the onset, time-to-progression, and severity of hearing loss.
Main Results:
- 35 out of 55 patients developed hearing loss, with incidence varying by age and combined therapies (chemotherapy and radiotherapy).
- Hearing loss occurred at cumulative cisplatin doses as low as 200 mg/m², with a median onset of 71 days post-treatment.
- Progressive hearing loss, persistent hearing failure, and the need for hearing aids were observed in several patients.
Conclusions:
- Ototoxicity from cisplatin therapy is a significant risk in pediatric cancer patients, influenced by age, combined treatments, and potentially genetic factors.
- Regular audiologic monitoring is crucial for all pediatric patients receiving cisplatin, regardless of cumulative dose.
- Further prospective research, including genetic polymorphism analysis, is needed to fully understand and manage cisplatin-induced ototoxicity.
Abstract:
Cisplatin is an effective chemotherapeutic agent against pediatric cancers; however, ototoxicity is a concern. This study describes the frequency, severity, and clinical course of hearing loss in Japanese pediatric patients treated with cisplatin-based multimodal therapy. A total of 55 children who received cisplatin-based therapy from 1983 to 2012 underwent audiologic evaluations. Data were analyzed to determine the onset, time-to-progression, and severity of hearing loss. Thirty-five patients, 12 of 16 older patients (4 y or older), and 23 of 39 younger patients (under 4 y), including 7 of 8 patients treated with cisplatin, carboplatin, and radiotherapy, developed hearing loss. Ten of 18 patients who received a cumulative cisplatin dose of <360 mg/m developed hearing loss at a minimum dose of 200 mg/m. Median time to onset after the last cisplatin dose was 71 days; 6 patients developed hearing loss after ≥2 years. Four patients required hearing aids, 6 patients developed progressive hearing loss with time, and 4 patients exhibited persistent hearing failure at low frequencies. Risk factors for acquired hearing loss and its severity may be associated with a combination of factors such as cisplatin and carboplatin therapy, radiotherapy, age at diagnosis, and genetic background. Our results suggested that all pediatric patients treated with cisplatin would have their hearing evaluated regularly, irrespective of the cumulative cisplatin dose as a suggestion, and that further prospective studies regarding ototoxicity including genetic polymorphisms analysis were required.
