Cisplatin ototoxicity in children: A practical grading system

✍ Scribed by Brock, Penelope R. ;Bellman, Susan C. ;Yeomans, Elizabeth C. ;Pinkerton, C. Ross ;Pritchard, Jon

• Book ID: 102949913
• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 568 KB
• Volume: 19
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/mpo.2950190415

✦ Synopsis

A long-term follow-up study was carried out to assess ototoxicity in children who had been treated for a malignant tumour with "standard dose" cisplatin (60-100 mg/m2 per course), and were at least 2 years from stopping treatment. The median age at diagnosis was 2 years 2 months (range 1 month to 13.5 years). On the basis of hearing assessment by pure-tone audiometry, a practical grading system of hearing loss from 0 to 4 is proposed. Moderate to severe high-frequency hearing loss (grade 2-4) was found in half the children and 10 require appropriate hearing aids. The risk of developing ototoxicity increased significantly with the cumulative cisplatin dose (P = 0.027), although there was considerable individual susceptibility. Serial follow-up testing, to a median of 4 years after completion of cisplatin treatment, showed no recovery of hearing in any of these children. We suggest careful monitoring of young children by a consultant audiological physician throughout treatment with cisplatin, particularly when doses of 400 mg/m2 and over have been reached. Alternative chemotherapy should be discussed if grade 2 ototoxicity develops.