Radiotherapy enhanced ototoxicity of cisplatin in children.
We reviewed and re-examined 31 children (6 months-14 years at the time of diagnosis), who had been treated for a neoplasm in Turku University Central Hospital between 1989 and 1994. The children were divided into 3 groups according to the site of the neoplasm and the type of therapy. Group I included 13 children, operated on for an intracranial tumor and received postoperative radio- and cisplatin-based chemotherapy. Group II included 14 children operated on for intracranial tumors and treated with radiotherapy, but not given chemotherapy. Group III included 4 children suffering from extracranial malignancies and they had received chemotherapy including cisplatin. The children in Group I had significantly worse hearing thresholds in the middle- and high-frequency range than children in Groups II and III. In a precise analysis of the different factors, no single dose of cisplatin, inner ear irradiation dose or totally to the central nervous system (CNS) received irradiation dose correlated to the detected hearing loss. However, multiple linear correlation analyses suggest a combined effect of radiotherapy plus cisplatin resulting in a high frequency hearing loss. This is in accordance with earlier random case reports, and supports the idea that radiotherapy should be considered cautiously in children treated with cisplatin for intracranial malignancies.
Miettinen
S
S
Department of Otolaryngology, Turku University Central Hospital, Finland.
Laurikainen
E
E
Johansson
R
R
Minn
H
H
Laurell
G
G
Salmi
T T
TT
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000628:therapy*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006316:Hearing Loss, High-Frequency / Q000139:chemically induced; D006319:Hearing Loss, Sensorineural / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D009369:Neoplasms / Q000628:therapy*; D011882:Radiotherapy, High-Energy / Q000009:adverse effects*; D012189:Retrospective Studies
D000970:Antineoplastic Agents; D002945:Cisplatin