title: Carboplatin-associated ototoxicity in children with retinoblastoma.
abstract: OBJECTIVE
  Carboplatin-induced ototoxicity remains poorly defined but is of potential great consequence in children with retinoblastoma. We retrospectively assessed the incidence of ototoxicity and its risk factors in children with retinoblastoma who were treated with carboplatin.
  
  
  METHODS
  We reviewed the audiologic test results of 60 patients with retinoblastoma who received front-line treatment with systemic carboplatin and vincristine according to the St Jude RET-3 protocol (n = 23) or best clinical management (n = 37). Ototoxicity was evaluated by three different grading systems.
  
  
  RESULTS
  Twelve patients (20%) developed ototoxicity at some time after treatment initiation; however, ototoxicity resolved in two patients, and thus,10 patients (17%) had sustained hearing loss as documented at their most recent audiologic evaluation. Nine of these 10 patients had grade 3 or 4 ototoxicity, and nine patients were less than 6 months of age at the start of chemotherapy. Age at the start of chemotherapy was the only risk factor identified as a significant predictor of sustained hearing loss. Younger age was associated with an increased incidence of hearing loss. The different ototoxicity grading systems showed good overall agreement in the identification of patients with ototoxicity. Agreement was greatest between the Brock and Children's Cancer Group systems.
  
  
  CONCLUSIONS
  We found that young patients with retinoblastoma who were treated with systemic carboplatin had a higher incidence of ototoxicity than previously reported. Younger patients (< 6 months of age at the start of treatment) were more likely to have ototoxicity than were older patients. Children treated with carboplatin should routinely undergo thorough, long-term audiologic monitoring.
authors.affiliation: St Jude Children's Research Hospital, Memphis, TN 38105-3678, USA. ibrahim.qaddoumi@stjude.org
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Qaddoumi
authors.forename: Johnnie K
authors.initials: JK
authors.lastname: Bass
authors.forename: Jianrong
authors.initials: J
authors.lastname: Wu
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Billups
authors.forename: Amy W
authors.initials: AW
authors.lastname: Wozniak
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Merchant
authors.forename: Barrett G
authors.initials: BG
authors.lastname: Haik
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Wilson
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Galindo
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006309:Hearing / Q000187:drug effects*; D034381:Hearing Loss / Q000139:chemically induced* / Q000453:epidemiology; D006320:Hearing Tests; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D019572:Retinal Neoplasms / Q000188:drug therapy*; D012175:Retinoblastoma / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D016190:Carboplatin