Long-term auditory follow-up in counteracting platinum-induced
ototoxicity in paediatric oncology
Abstract
Background. Irreversible bilateral sensorineural hearing loss is a
common side effect of platinum compounds. Because of extended overall
survival period of children, a prolonged hearing surveillance and
management of hearing impairments are emerging concerns for pediatric
oncology. Methods. In this retrospective observational study we enrolled
38 children out of 116 treated at our institution by chemotherapy
(cisplatin and/or carboplatin) with or without irradiation between
2007–2014, and submitted to hearing monitoring before every cycle of
chemotherapy and that completed a 5 years long-term follow-up.
Chemotherapy regimens, demographic findings, cumulative doses and
cranial irradiation were compared. Results. At the end of 5-years
follow-up ototoxicity was significantly increased compared to that at
observed the end of chemotherapy (52.5% vs 39.5%, p<0.001).
A late onset of hearing loss was experienced in 13.1% of children while
in 26.3% progressive hearing loss was measured. Deafness at the end of
chemotherapy and irradiation was significant prognostic factor for late
ototoxicity outcomes (Odds Ratio 7.2 – CI:1.67–31.1 –
p<0.01 and 5.25 – CI:1.26–21.86 – p<0.01
respectively). No significant differences were found between cisplatin
and combined treatment (i.e. cisplatin shifted to carboplatin during
monitoring for the onset of ototoxicity) and ototoxicity was not
associated with platinum compounds cumulative dose
(p>0.05). 13.1% of children needed hearing aids at the end
of follow-up. Conclusions. Our study confirms the effectiveness of
long-term follow-up in identifying late onset/progressive hearing loss
after platinum compound chemotherapy and allows us to avoid the harmful
effects of hearing deprivation with hearing aid intervention.