title: Long-term auditory complications after childhood cancer: A report from the Swiss Childhood Cancer Survivor Study.
abstract: Auditory complications are an adverse event of childhood cancer treatment, especially common in children treated with platinum chemotherapy or cranial radiation. Variation between diagnostic childhood cancer groups has rarely been studied, and we do not know if the burden of auditory complications has changed over the last decades.
  
  
  
  Within the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to all survivors who were diagnosed at age 16 years or less between 1976 and 2005. We compared prevalence of self-reported hearing loss and tinnitus between all diagnostic childhood cancer groups and siblings, used multivariable logistic regression to analyze the effect of treatment-related factors on hearing loss, and compared the cumulative incidence of hearing loss between different periods of cancer diagnosis.
  
  
  
  Prevalence of self-reported hearing loss was higher in survivors (10%) than in siblings (3%, P < 0.001), and highest in survivors of central nervous system tumors (25%). Significant risk factors were treatment with platinum compounds (carboplatin: odds ratio [OR] 2.4; cisplatin: OR 9.4), cranial radiation (>29 Gy: OR >1.7), or brain surgery (OR 2.2). Children diagnosed in 1986-1995, when platinum compounds came into widespread use, had a significantly higher cumulative incidence of hearing loss than those diagnosed in 1976-1985. In the most recent period, 1996-2005, the risk decreased again, both for patients treated with platinum compounds and with cranial radiation.
  
  
  
  Our data show that the burden of hearing loss has stabilized in recently treated survivors, suggesting that survivors have benefited from new treatment regimens that use less ototoxic radiation and more carefully dosed platinum compounds.
authors.affiliation: Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Annette
authors.initials: A
authors.lastname: Weiss
authors.affiliation: Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Grit
authors.initials: G
authors.lastname: Sommer
authors.affiliation: Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Rahel
authors.initials: R
authors.lastname: Kasteler
authors.affiliation: Division of Pediatric Hematology/Oncology, University Children's Hospital Basel, Basel, Switzerland.
authors.forename: Katrin
authors.initials: K
authors.lastname: Scheinemann
authors.affiliation: Department of Pediatric Oncology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Grotzer
authors.affiliation: Department of ENT, Head and Neck Surgery, University Hospital Bern, University of Bern, Bern, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Kompis
authors.affiliation: Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Kuehni
authors.affiliation: Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
keywords: Europe; cancer registry; childhood cancer survivors; cranial radiation; ototoxicity; platinum compounds