Asymmetric sensorineural hearing loss is a risk factor for late‐onset hearing loss in pediatric cancer survivors following cisplatin treatment

Robertson, Margaret S.; Hayashi, Susan S.; Camet, Miranda L.; Trinkaus, Kathryn; Henry, Jennifer; Hayashi, Robert J.

doi:10.1002/pbc.27494

Cited by 7 publications

(4 citation statements)

References 32 publications

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“…Solid tumor patients often receive radiation to the site of their tumor, typically in the abdomen. A recent report demonstrated that radiation to parts of the body other than the head or neck was a risk factor for the development of late onset hearing loss in cisplatin‐treated patients 18 . In a separate report from the CCSS, it was reported that patients were at a significantly increased risk of developing a chronic health condition subsequent to radiation therapy 19 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of hearing screening failures in low‐risk childhood cancer survivors

Phelan

Hayashi

Sauerburger

et al. 2021

Pediatric Blood & Cancer

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Background:We sought to estimate the frequency of hearing screening failures in pediatric cancer survivors at low risk for hearing loss and evaluate the feasibility of administering screenings in this population.Procedure: Survivors in the St. Louis Children's Hospital Late Effects Clinic were recruited. Eligibility included (a) diagnosis of a pediatric cancer treated without platinum chemotherapy or cranial radiation, (b) at least 6 months from completion of therapy, (c) between the ages of 7 and 18 years, (d) cognitively/behaviorally able to participate, and (e) English speaking. Behavioral hearing screenings from 1000 to 8000 Hz were performed by trained personnel using a calibrated audiometer. A failed screen was defined by a participant not responding to two or more of the three screening attempts for at least one frequency in at least one ear.Results: One hundred nine patients met eligibility criteria with 78 enrolled (71.5%).Diagnoses included leukemia (57.7%), sarcoma (11.5%), Wilms tumor (14.1%), lymphoma (12.8%), and other solid tumors (3.9%). The median age was 13.2 years (Q1-Q3: 9.6-15.4) and the median time from treatment completion was 3.7 years (Q1-Q3: 2.3-7.4). Eighteen patients (23%) failed the hearing screen (95% CI: 14%-34%). No demographic or treatment-related variables were significantly correlated to screening failure. Six screen failures (33%) underwent formal audiology assessments, with three demonstrating unilateral hearing loss: two conductive and one sensorineural.Conclusions: A significant fraction of pediatric cancer survivors at low risk for hearing loss failed hearing screening. Broader use of hearing screening should be considered.

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Section: Introductionmentioning

confidence: 99%

Prevalence of hearing screening failures in low‐risk childhood cancer survivors

Phelan

Hayashi

Sauerburger

et al. 2021

Pediatric Blood & Cancer

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“…Radiation to any part of the body was also shown to be a risk factor, with radiation directly to the head failing to achieve significance in multivariate analysis. Our previous investigations had established radiation to locations other than the head still place patients at risk for hearing loss ( 16 ). Radiation can lead to circulating free radicals and inflammatory mediators that have been reported to impact organs and tissues distant from the organ targeted for radiation (ascopal effect) ( 22 , 23 ).…”

Section: Discussionmentioning

confidence: 99%

“…A substantial effort was made to ensure clear audiologic data. To uphold the audiologic parameters utilized in our previously reported investigations, we adhered to formerly established criterion to ensure the study subjects had treatment acquired, ear specific, sensorineural hearing loss ( 16 ). This resulted in the exclusion of many patients but created a pediatric population with less ambiguous hearing profiles and allowed for a more rigorous investigation into the presence of ototoxic hearing loss in this population.…”

Section: Methodsmentioning

confidence: 99%

Cisplatin Ototoxicity: Examination of the Impact of Dosing, Infusion Times, and Schedules In Pediatric Cancer Patients

et al. 2021

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BackgroundSensorineural hearing loss is a well-known side effect of cisplatin (CDDP). There is limited research on the effect of dosing, infusion times, and schedules of cisplatin administration and their impact on hearing loss.MethodsA retrospective review of 993 pediatric patients’ medical and audiological charts from August 1990 to March 2015 was conducted using stringent inclusion criteria to characterize patients with hearing loss. 248 of these patients received CDDP. Of these, 216 patients had sufficient CDDP infusion data to assess for sensorineural hearing loss attributable to CDDP and its associated risk factors. Chart reviews were performed to extract clinical data including CDDP dosing information. Demographic and clinical characteristics were summarized by descriptive statistics, and univariate and multivariate logistic regressions were performed to examine the relationship between hearing loss and specific parameters of cisplatin administration (amount infused per dose, prescribed infusion time, total number of doses, number of doses per cycle, number of cycles, cumulative cisplatin exposure). Stepwise variable selection procedure was performed in the multivariate model building to extract the best subset of risk factors for the prediction of hearing loss and worsening ototoxicity grade using an established ototoxicity grading scale from the International Society of Pediatric Oncology (SIOP).ResultsA total of 153 patients with complete medical and audiologic data were evaluable for analysis. Hearing loss was identified in 72.6% of the patients. Multivariate analysis revealed that age [OR=0.90 (0.84-0.97), p-value=0.0086], radiation to any part of the body, [OR=3.20 (1.29-7.93), p-value=0.012], amount infused per dose (mg/m2) [OR=1.018 (1.002-1.033), p-value=0.029], and cumulative cisplatin exposure (mg/m 2) [OR=1.004 (1-1.008), p-value=0.027] were associated with hearing loss. Similar associations were also found between these risk factors and worsening SIOP grade.ConclusionIn one of the largest studies examining the influence of CDDP dosing and schedules on hearing loss, we found the amount of CDDP infused per dose is a significant risk factor. Considerations in designing regimens that reduce the amount of CDDP infused per dose may reduce the risk of hearing loss. Randomized prospective trials are needed.

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“…Subsequent follow-up studies would be needed if hearing loss was detected, to ensure no further worsening of hearing. Late-onset hearing loss has been observed in pediatric cancer patients receiving ototoxic chemotherapy, suggesting that patients who sustain ototoxic insults may experience further declines in hearing [29]. This will ensure that children with such losses are given the best chance to succeed in the classroom and in the workplace.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Ototoxicity Following Hematopoietic Stem Cell Transplantation in Pediatric Patients

Gertson

Hayashi

Trinkaus

et al. 2020

Biology of Blood and Marrow Transplantation

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The use of hematopoietic stem cell transplantation (HSCT) is increasing for a variety of diseases. Ototoxicity from this procedure has not been extensively studied. A retrospective chart review examined 275 patients from this institution who underwent HSCT between January 1, 2007, and April 30, 2017. Data extracted included therapy before HSCT and the subsequent course of transplantation. Evaluable patients had complete medical records and interpretable audiograms available. Ototoxicity constituted significant threshold changes from baseline or changes in International Society of Pediatric Oncology/Boston Ototoxicity Grading Scale (SIOP) grade comparing audiogram results just before HSCT with those following the transplantation procedure. A total of 147 patients were evaluable. Ototoxicity was observed in 10.2% of the patients. Higher SIOP grade before HSCT was significantly associated with a higher risk of post-transplantation ototoxicity (P < .01). Previous cisplatin treatment (P < .0001), but not carboplatin or radiation treatment, was also associated with ototoxicity. Patients with a solid tumor or brain tumor (P < .0001) and those who received an autologous transplant (P = .0002) were also at increased risk. No post-transplantation event was significantly associated with ototoxicity. Ototoxicity affects a significant percentage of patients undergoing HSCT, and careful monitoring is needed to identify patients impacted by this procedure.

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Asymmetric sensorineural hearing loss is a risk factor for late‐onset hearing loss in pediatric cancer survivors following cisplatin treatment

Cited by 7 publications

References 32 publications

Prevalence of hearing screening failures in low‐risk childhood cancer survivors

Prevalence of hearing screening failures in low‐risk childhood cancer survivors

Cisplatin Ototoxicity: Examination of the Impact of Dosing, Infusion Times, and Schedules In Pediatric Cancer Patients

Prevalence of Ototoxicity Following Hematopoietic Stem Cell Transplantation in Pediatric Patients

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