title: Auditory complications in childhood cancer survivors: a report from the childhood cancer survivor study.
abstract: BACKGROUND
  Studies have found associations between cancer therapies and auditory complications, but data are limited on long-term outcomes and risks associated with multiple exposures.
  
  
  METHODS
  The Childhood Cancer Survivor Study is a retrospective cohort investigating health outcomes of long-term survivors (5+ years) diagnosed and treated between 1970 and 1986 compared to a randomly selected sibling cohort. Questionnaires were completed by 14,358 survivors of childhood cancer and 4,023 sibling controls. Analysis determined the first occurrence of four auditory conditions in two time periods: diagnosis to 5 years post-diagnosis, and ≥ 5 years post-diagnosis. Multivariable analyses determined the relative risks (RR) and 95% confidence interval (CI) of auditory conditions by treatment exposure.
  
  
  RESULTS
  Five or more years from cancer diagnosis, survivors were at increased risk of problems hearing sounds (RR = 2.3; 95% CI: 1.8-2.8), tinnitus (RR = 1.7; 95% CI: 1.4-2.1), hearing loss requiring an aid (RR = 4.4; 95% CI: 2.8-6.9), and hearing loss in 1 or both ears not corrected by a hearing aid (RR = 5.2; 95% CI: 2.8-9.5), when compared to siblings. Temporal lobe and posterior fossa radiation was associated with these outcomes in a dose-dependent fashion. Exposure to platinum compounds was associated with an increased risk of problems hearing sounds (RR = 2.1; 95% CI: 1.3-3.2), tinnitus (RR = 2.8; 95% CI: 1.9-4.2), and hearing loss requiring an aid (RR = 4.1; 95% CI: 2.5-6.7).
  
  
  CONCLUSIONS
  Childhood cancer survivors are at risk of developing auditory complications. Radiation and platinum compounds are determinants of this risk. Follow-up is needed to evaluate the impact of auditory conditions on quality of life.
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA. kwhelan@peds.uab.edu
authors.forename: Kimberly
authors.initials: K
authors.lastname: Whelan
authors.forename: Kayla
authors.initials: K
authors.lastname: Stratton
authors.forename: Toana
authors.initials: T
authors.lastname: Kawashima
authors.forename: Wendy
authors.initials: W
authors.lastname: Leisenring
authors.forename: Susan
authors.initials: S
authors.lastname: Hayashi
authors.forename: John
authors.initials: J
authors.lastname: Waterbor
authors.forename: Julie
authors.initials: J
authors.lastname: Blatt
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sklar
authors.forename: Roger
authors.initials: R
authors.lastname: Packer
authors.forename: Pauline
authors.initials: P
authors.lastname: Mitby
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D034381:Hearing Loss / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000628:therapy*; D017671:Platinum Compounds / Q000009:adverse effects / Q000627:therapeutic use; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D035781:Siblings; D013997:Time Factors; D055815:Young Adult
chemical_list: D017671:Platinum Compounds