BACKGROUND: Cisplatin (CDDP) ototoxicity is a significant side effect of the current treatment of medulloblastoma (MB). Cumulative dose of CDDP and age are recognized risk factors for hearing loss, but inter-individual susceptibility limits our ability to identify patients at risk for hearing loss. We describe the kinetics of early audiometric changes during therapy and identify profiles associated with a higher risk of needing hearing aids. PROCEDURE: Serial audiometric evaluations were performed during and after completion of therapy in children with average risk (AR) and high-risk (HR) MB. Each audiogram was scored according to five grading systems. Variations of pure tone thresholds were analyzed at each frequency for each consecutive audiogram. CDDP dose modifications and hearing outcome were recorded. RESULTS: A total of 258 audiograms from 35 patients (22 AR, 13 HR) were analyzed. Eighteen AR patients (81.3%) required dose reduction and the median cumulative dose of CDDP administered was 412.5 mg/m(2) (150-600), corresponding to 68% of the intended dose. Three HR patients (23.0%) required dose reduction. At a median follow-up of 67 months (11-117), nine patients (25.7%) required hearing support: After two cycles of CDDP (150 mg/m(2) ), the average hearing loss at 8,000 Hz was twice higher in the group that eventually required hearing support. CONCLUSION: Early alteration of high-frequency thresholds may help identify individuals who will require hearing support. In the MB population, alternative strategies should be developed to limit the cumulative dose of CDDP to prevent significant ototoxicity.
BACKGROUND:Cisplatin (CDDP) ototoxicity is a significant side effect of the current treatment of medulloblastoma (MB). Cumulative dose of CDDP and age are recognized risk factors for hearing loss, but inter-individual susceptibility limits our ability to identify patients at risk for hearing loss. We describe the kinetics of early audiometric changes during therapy and identify profiles associated with a higher risk of needing hearing aids. PROCEDURE: Serial audiometric evaluations were performed during and after completion of therapy in children with average risk (AR) and high-risk (HR) MB. Each audiogram was scored according to five grading systems. Variations of pure tone thresholds were analyzed at each frequency for each consecutive audiogram. CDDP dose modifications and hearing outcome were recorded. RESULTS: A total of 258 audiograms from 35 patients (22 AR, 13 HR) were analyzed. Eighteen AR patients (81.3%) required dose reduction and the median cumulative dose of CDDP administered was 412.5 mg/m(2) (150-600), corresponding to 68% of the intended dose. Three HR patients (23.0%) required dose reduction. At a median follow-up of 67 months (11-117), nine patients (25.7%) required hearing support: After two cycles of CDDP (150 mg/m(2) ), the average hearing loss at 8,000 Hz was twice higher in the group that eventually required hearing support. CONCLUSION: Early alteration of high-frequency thresholds may help identify individuals who will require hearing support. In the MB population, alternative strategies should be developed to limit the cumulative dose of CDDP to prevent significant ototoxicity.
Authors: Claudia Lanvers-Kaminsky; Jason A Sprowl; Ingrid Malath; Dirk Deuster; Maria Eveslage; Eberhard Schlatter; Ron Hj Mathijssen; Joachim Boos; Heribert Jürgens; Antionette G Am Zehnhoff-Dinnesen; Alex Sparreboom; Giuliano Ciarimboli Journal: Pharmacogenomics Date: 2015 Impact factor: 2.533
Authors: James G Gurney; Johnnie K Bass; Arzu Onar-Thomas; Jie Huang; Murali Chintagumpala; Eric Bouffet; Tim Hassall; Sridharan Gururangan; John A Heath; Stewart Kellie; Richard Cohn; Michael J Fisher; Atmaram Pai Panandiker; Thomas E Merchant; Ashok Srinivasan; Cynthia Wetmore; Ibrahim Qaddoumi; Clinton F Stewart; Gregory T Armstrong; Alberto Broniscer; Amar Gajjar Journal: Neuro Oncol Date: 2014-01-10 Impact factor: 12.300
Authors: A Dimitrios Colevas; Ruth R Lira; Electra A Colevas; Philip W Lavori; Cato Chan; David B Shultz; Kay W Chang Journal: Head Neck Date: 2014-07-11 Impact factor: 3.147
Authors: E Clemens; B Brooks; A C H de Vries; M van Grotel; M M van den Heuvel-Eibrink; B Carleton Journal: PLoS One Date: 2019-02-14 Impact factor: 3.240