title: Audiological profile of patients treated for childhood cancer.
abstract: OBJECTIVE
  To characterize the hearing loss after cancer treatment, according to the type of treatment, with identification of predictive factors.
  
  
  METHODS
  Two hundred patients who had cancer in childhood were prospectively evaluated. The mean age at diagnosis was 6 years, and at the audiometric assessment, 21 years. The treatment of the participants included chemotherapy without using platinum derivatives or head and neck radiotherapy in 51 patients; chemotherapy using cisplatin without radiotherapy in 64 patients; head and neck radiotherapy without cisplatin in 75 patients; and a combined treatment of head and neck radiotherapy and chemotherapy with cisplatin in ten patients. Patients underwent audiological assessment, including pure tone audiometry, speech audiometry, and immittancemetry.
  
  
  RESULTS
  The treatment involving chemotherapy with cisplatin caused 41.9% and 47.3% hearing loss in the right and left ear, respectively, with a 11.7-fold higher risk of hearing loss in the right ear and 17.6-fold higher in the left ear versus patients not treated with cisplatin (p<0.001 and p<0.001, respectively). Children whose cancer diagnosis occurred after the age of 6 have shown an increased risk of hearing loss vs. children whose diagnosis occurred under 6 years of age (p=0.02).
  
  
  CONCLUSIONS
  The auditory feature found after the cancer treatment was a symmetrical bilateral sensorineural hearing loss. Chemotherapy with cisplatin proved to be a risk factor, while head and neck radiotherapy was not critical for the occurrence of hearing loss.
authors.affiliation: Núcleo de Audiologia do A.C. Camargo Cancer Center, São Paulo, SP, Brazil. Electronic address: phpliberman@accamargo.org.br.
authors.forename: Patricia Helena Pecora
authors.initials: PH
authors.lastname: Liberman
authors.affiliation: Núcleo de Audiologia do A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
authors.forename: Maria Valéria Schmidt
authors.initials: MV
authors.lastname: Goffi-Gomez
authors.affiliation: Núcleo de Audiologia do A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
authors.forename: Christiane
authors.initials: C
authors.lastname: Schultz
authors.affiliation: Hospital Vitoria, Santos, SP, Brazil.
authors.forename: Paulo Eduardo
authors.initials: PE
authors.lastname: Novaes
authors.affiliation: Hospital de Câncer de Barretos, Departamento de Pediatria, Barretos, SP, Brazil.
authors.forename: Luiz Fernando
authors.initials: LF
authors.lastname: Lopes
mesh_terms: D000367:Age Factors; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005260:Female; D006312:Hearing Loss, Bilateral / Q000175:diagnosis / Q000209:etiology*; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Audição; CDDP; Chemotherapy; Cisplatin; Cisplatina; Hearing; Hearing loss; Ototoxicidade; Ototoxicity; Perda auditiva; Quimioterapia; Radioterapia; Radiotherapy