title: Cisplatin ototoxicity in children: a practical grading system.
abstract: A long-term follow-up study was carried out to assess ototoxicity in children who had been treated for a malignant tumour with "standard dose" cisplatin (60-100 mg/m2 per course), and were at least 2 years from stopping treatment. The median age at diagnosis was 2 years 2 months (range 1 month to 13.5 years). On the basis of hearing assessment by pure-tone audiometry, a practical grading system of hearing loss from 0 to 4 is proposed. Moderate to severe high-frequency hearing loss (grade 2-4) was found in half the children and 10 require appropriate hearing aids. The risk of developing ototoxicity increased significantly with the cumulative cisplatin dose (P = 0.027), although there was considerable individual susceptibility. Serial follow-up testing, to a median of 4 years after completion of cisplatin treatment, showed no recovery of hearing in any of these children. We suggest careful monitoring of young children by a consultant audiological physician throughout treatment with cisplatin, particularly when doses of 400 mg/m2 and over have been reached. Alternative chemotherapy should be discussed if grade 2 ototoxicity develops.
authors.affiliation: Department of Haematology and Oncology, Hospitals for Sick Children, London, England.
authors.forename: P R
authors.initials: PR
authors.lastname: Brock
authors.forename: S C
authors.initials: SC
authors.lastname: Bellman
authors.forename: E C
authors.initials: EC
authors.lastname: Yeomans
authors.forename: C R
authors.initials: CR
authors.lastname: Pinkerton
authors.forename: J
authors.initials: J
authors.lastname: Pritchard
mesh_terms: D000293:Adolescent; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000009:adverse effects*; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006316:Hearing Loss, High-Frequency / Q000139:chemically induced* / Q000145:classification; D006801:Humans; D007223:Infant; D008991:Monitoring, Physiologic
chemical_list: D002945:Cisplatin