title: Late onset hearing loss: a significant complication of cancer survivors treated with Cisplatin containing chemotherapy regimens.
abstract: Cisplatin is a known ototoxic agent and has been associated with late onset hearing loss (LOHL) in children beyond completion of treatment. We completed a retrospective review of 160 patients yielding 59 who received cisplatin and had sufficient data to determine the presence of LOHL. LOHL was defined as a significant change in hearing thresholds 6 months past the last cisplatin therapy. A significant change was defined as a decrease of >15 dB in a frequency from 1 to 8 kHz in either ear, or a decrease of 10 dB at 2 or more frequencies in the same ear, compared with the previously entered audiogram. Hearing loss was classified using the Brock grading system for each ear. Of the 59 patients evaluated, 51% exhibited LOHL. Univariate analysis indicated LOHL was significantly associated with age of diagnosis (P=0.031), diagnosis of medulloblastoma (P=0.035), hearing aids (P=0.010), and cranial radiation (P=0.044), particularly to the posterior fossa (P=0.023). Multivariate analysis revealed only radiation to the posterior fossa (P=0.02) and the use of hearing aids (P=0.01) were significantly associated with LOHL. LOHL is a significant complication in childhood cancer survivors who receive cisplatin. Long-term audiologic monitoring after therapy is needed to identify the affected patients.
authors.affiliation: Department of Pediatrics, Division of Hematology/Oncology, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Kolinsky
authors.forename: Susan S
authors.initials: SS
authors.lastname: Hayashi
authors.forename: Roanne
authors.initials: R
authors.lastname: Karzon
authors.forename: Jingnan
authors.initials: J
authors.lastname: Mao
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hayashi
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000009:adverse effects*; D003051:Cochlea / Q000187:drug effects; D005260:Female; D034381:Hearing Loss / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D017741:Survivors
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin