title: Ototoxicity in children receiving platinum chemotherapy: underestimating a commonly occurring toxicity that may influence academic and social development.
abstract: OBJECTIVE
  To describe the frequency and severity of ototoxicity in a series of pediatric patients treated with platinum-based chemotherapy.
  
  
  METHODS
  Serial audiologic evaluations were conducted for 67 patients aged 8 months to 23 years who received platinum-based chemotherapy. Audiologic data was analyzed to determine time to hearing-loss using American Speech-Language-Hearing Association (ASHA) criteria, and the effects of treatment and patient characteristics on the incidence and severity of ototoxicity.
  
  
  RESULTS
  Bilateral decreases in hearing were seen in 61% of patients (median time to hearing loss, 135 days). Children treated for medulloblastoma, osteosarcoma, and neuroblastoma had greater incidence and severity of hearing loss. Agreement between the usually reported National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) and ASHA criteria was inadequate.
  
  
  CONCLUSIONS
  Traditional reporting of toxicity data (CTCAE) has under-reported ototoxicity and minimized the significance of hearing loss in children. As pediatric patients experience improved survival, the effects and implications of high-frequency hearing loss with regard to academic achievement and speech and language development are important considerations, especially in patients younger than 5 years.
authors.affiliation: Department of Neurology, Neurosurgery, and Pediatric Audiology, Oregon Health and Science University, Portland 97201, USA.
authors.forename: Kristin R Gilmer
authors.initials: KR
authors.lastname: Knight
authors.forename: Dale F
authors.initials: DF
authors.lastname: Kraemer
authors.forename: Edward A
authors.initials: EA
authors.lastname: Neuwelt
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy; D016190:Carboplatin / Q000009:adverse effects / Q000627:therapeutic use; D002528:Cerebellar Neoplasms / Q000188:drug therapy; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006312:Hearing Loss, Bilateral / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy; D009447:Neuroblastoma / Q000188:drug therapy; D009922:Oregon / Q000453:epidemiology; D012516:Osteosarcoma / Q000188:drug therapy; D010033:Otitis Media / Q000139:chemically induced* / Q000473:pathology; D017671:Platinum Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D017671:Platinum Compounds; D016190:Carboplatin; D002945:Cisplatin