cis-platinum ototoxicity in children.
Despite the recognized ototoxicity of cis-platinum, a clinical outline for the audiologic evaluation of patients receiving this drug has not been clearly defined. In a practical approach to this problem, the audiograms of 48 pediatric patients referred for monitoring during planned cis-platinum therapy were reviewed. Eleven patients tested with auditory brain-stem response (ABR) audiometry demonstrated several limitations of this modality. Fourteen children underwent initial ABR testing followed by at least two pure-tone audiograms. The remaining 23 patients had their hearing evaluated by pure-tone audiometry only. Various factors such as patient age, cis-platinum dosage, and cranial radiation exposure were analyzed for apparent effect. Younger patients tended to be more susceptible to audiologic changes with the administration of cis-platinum. The proportion of patients who demonstrated a hearing loss increased with successive dosing as did the severity of the hearing loss. Prior exposure to cranial radiation was strongly linked to the development of hearing loss following cis-platinum therapy. Guidelines are presented regarding the use of clinical audiometry in the screening of these pediatric oncology patients.
Weatherly
R A
RA
Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, TX 77030.
Owens
J J
JJ
Catlin
F I
FI
Mahoney
D H
DH
D000293:Adolescent; D001301:Audiometry, Pure-Tone; D001921:Brain / Q000528:radiation effects; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D012189:Retrospective Studies
D002945:Cisplatin