<i>Cis</i>‐Platinum ototoxicity in children

TLDR

Despite the known ototoxicity of cis‑platinum, no clear clinical audiologic evaluation outline exists for patients receiving this drug. The study presents guidelines for using clinical audiometry to screen pediatric oncology patients treated with cis‑platinum. Audiograms from 48 children were reviewed, with 14 undergoing initial ABR followed by multiple pure‑tone audiograms, 23 assessed only by pure‑tone audiometry, and age, cis‑platinum dose, and cranial radiation exposure analyzed for effects. ABR audiometry revealed limitations, and younger age, higher cumulative cis‑platinum dose, and prior cranial radiation were linked to greater incidence and severity of hearing loss.

Abstract

Despite the recognized ototoxicity of cis-platinum, a clinical outline for the audiologic evaluation of patients receiving this drug has not been clearly defined. In a practical approach to this problem, the audiograms of 48 pediatric patients referred for monitoring during planned cis-platinum therapy were reviewed. Eleven patients tested with auditory brain-stem response (ABR) audiometry demonstrated several limitations of this modality. Fourteen children underwent initial ABR testing followed by at least two pure-tone audiograms. The remaining 23 patients had their hearing evaluated by pure-tone audiometry only. Various factors such as patient age, cis-platinum dosage, and cranial radiation exposure were analyzed for apparent effect. Younger patients tended to be more susceptible to audiologic changes with the administration of cis-platinum. The proportion of patients who demonstrated a hearing loss increased with successive dosing as did the severity of the hearing loss. Prior exposure to cranial radiation was strongly linked to the development of hearing loss following cis-platinum therapy. Guidelines are presented regarding the use of clinical audiometry in the screening of these pediatric oncology patients.