Predicting cisplatin ototoxicity in children: the influence of age and the cumulative dose.
The aim of this study was to determine the risk factors for high-frequency hearing loss in children treated with cisplatin. We scored off-treatment pure-tone audiograms from 153 children (age 6 months to 18 years) who had completed cisplatin therapy (40-200 mg/m(2)/cycle) for germ cell tumours, hepatoblastoma, neuroblastoma or osteosarcoma. The risk of developing bilateral moderate to severe high-frequency hearing loss was significantly related to the age at treatment (P<0.001), and individual and cumulative cisplatin dosages (both P<0.005). Logistic regression showed that children younger than 5 years were at a greater risk of sustaining cisplatin ototoxicity than children older than 15 years, controlling for individual and cumulative doses of cisplatin (Odds Ratio (OR)=21.17, 95% Confidence Interval (CI): 2.48-180.94). Age at treatment and the cumulative dose of cisplatin were the two most important risk factors in predicting moderate to severe high-frequency hearing loss in children treated with cisplatin.
Li
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The Center for Outcomes Research, The Children's Hospital of Philadelphia, 3535 Market St. Suite 1029. Philadelphia, PA 19104, USA. yuelin@mail.med.upenn.edu
Womer
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RB
Silber
J H
JH
D000293:Adolescent; D000367:Age Factors; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000009:adverse effects*; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D005260:Female; D006316:Hearing Loss, High-Frequency / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors
D000970:Antineoplastic Agents; D002945:Cisplatin