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Preventing Hearing Loss in Children Receiving Cisplatin: A Systematic Review and Meta-Analysis.
Ethan M Kallenberger1, Erin E Briggs1,2, Shaun A Nguyen1
1Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
The Laryngoscope
|April 1, 2025
Summary
Preventing cisplatin-induced hearing loss in children shows mild success with interventions like sodium thiosulfate or amifostine. Further research is needed due to limited literature on ototoxicity prevention.
Area of Science:
- Pediatric Oncology
- Ototoxicology
- Clinical Pharmacology
Background:
- Cisplatin chemotherapy is a critical treatment for pediatric cancers.
- Cisplatin-induced hearing loss (ototoxicity) causes significant long-term neurologic, social, and behavioral deficits in children.
- Effective preventive strategies for cisplatin ototoxicity are crucial for improving quality of life.
Purpose of the Study:
- To review and characterize available interventions for preventing cisplatin-induced hearing loss in pediatric patients.
- To identify gaps in the current scientific literature regarding ototoxicity prevention in children receiving cisplatin.
Main Methods:
- A systematic literature search was conducted across CINAHL, Cochrane Library, PubMed, and Scopus databases from 1990 to 2024.
- Studies evaluating interventions to prevent hearing loss in children undergoing cisplatin treatment were included.
- Audiometric data, including pure tone thresholds and hearing loss incidence, were extracted and analyzed.
Main Results:
- Six studies (N=760) involving four randomized controlled trials, one non-randomized controlled trial, and one prospective cohort study were analyzed.
- Intravenous sodium thiosulfate or amifostine were the primary interventions examined.
- Interventions showed a reduced relative risk of hearing loss (0.78) and significantly increased the proportion of patients with no hearing impairment (Brock grade zero: 36.3% vs. 15.5%).
Conclusions:
- Available evidence suggests mild success in mitigating cisplatin-induced hearing loss in children.
- The current body of literature is limited, underscoring the need for more robust clinical trials.
- Further investigation is warranted to establish definitive preventive strategies for pediatric cisplatin ototoxicity.
