Background. The changes and general alarm of the current COVID-19 pandemic have amplified the sense of precariousness and vulnerability for family members who, in addition to the emotional trauma of the cancer diagnosis, add the distress and fear of the risks associated with infection. The primary objectives of the present study was to investigate the psychological impact of the COVID-19 pandemic on the parents of pediatric cancer patients, and to investigate the level of stress, anxiety, and the child’s quality of life perceived by the parents during the Covid-19 epidemic. Methods. The parents of 45 consecutive children with solid and haematological tumors were enrolled. Four questionnaires (Impact of Event Scale-Revised - IES-R ; Perceived Stress Scale - PSS; Spielberger State - Trait Anxiety Inventory - STAI-Y ; Pediatric Quality of Life Inventory - PedsQL) were administered to the parents at the beginning of the pandemic lockdown. Results. 75% of parents exhibited remarkable levels of anxiety, with 60 subjects in state scale and 45 subjects in trait scale having scores that reached and exceeded the STAI-Y cut off. The bivariate matrix of correlation (Figure 1) found a strong significant positive correlation between the IES-R and PSS scores (r = 0.55, P < 0.001). There was a positive correlations between the PSS and PedsQL (emotional needs) scale (P < 0.001) and a negative correlation between IES-R and STAI-Y (P < 0.001). Conclusion. The results confirm that parents of pediatric cancer patients have a high psychological risk for post-traumatic symptoms, high stress levels, and the presence of clinically significant levels of anxiety.

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.