Clin Pediatr Hematol Oncol.  2017 Oct;24(2):121-129. 10.15264/cpho.2017.24.2.121.

Adverse Factors and the Role of Cisplatin and Vinca Alkaloids for Hearing Impairment in Childhood Cancer Patients and Survivors

• Hur MW
• Hahn SM
• Moon IS
• Lim JY
• Lee SM
• Lyu CJ
• Han JW

• KMID: 2396013
• DOI: http://doi.org/10.15264/cpho.2017.24.2.121

Abstract

BACKGROUND
Although combined chemotherapy has increased survival rates among children with cancer, such treatments can induce sensorineural hearing loss. Therefore, we aimed to identify risk factors for hearing impairments in patients with childhood cancer.
METHODS
Audiograms were obtained from 115 patients with childhood cancer and survivors (age < 20 years). Pure tone audiometry (PTA) was performed at octave intervals within the range of 250-8000 Hz. We evaluated clinical risk factors associated with hearing impairments. Hearing loss was evaluated based on the maximal decibel (dB) loss in any frequency for each ear (RA(max) or LA(max)) and weighted mean dB loss for specific frequencies (RA(avg) or LA(avg)).
RESULTS
Forty percent of patients (N=46) exhibited hearing loss >20 dB based on the weighted mean value in either ear. Severe hearing impairments were observed in 56% of patients with brain tumors. Although cisplatin or vinca alkaloids were significant risk factors for hearing impairment, the use of both cisplatin and vinca alkaloids exhibited the highest odds ratio for hearing impairment (P < 0.001, < 0.001 for R/LA(max); P=0.099, 0.039 for R/LA(avg)). Multivariate analysis revealed that the use of both cisplatin and vinca alkaloids was an independent risk factor for hearing impairment based on RA(max), LA(max), and LA(avg) (P < 0.001, < 0.001, 0.039, respectively).
CONCLUSION
Our findings indicate that cisplatin and vinca alkaloids exert an additive effect on the risk of hearing impairment in survivors of childhood cancer. Further prospective studies are thus required to determine the most effective chemotherapeutic regimen for reducing ototoxicity.

Keyword

Survivors; Hearing loss; Neoplasms; Cisplatin; Vinca alkaloids

MeSH Terms

Audiometry
Brain Neoplasms
Child
Cisplatin*
Drug Therapy
Ear
Hearing Loss*
Hearing Loss, Sensorineural
Hearing*
Humans
Multivariate Analysis
Odds Ratio
Prospective Studies
Risk Factors
Survival Rate
Survivors*
Vinca Alkaloids*
Vinca*
Cisplatin
Vinca Alkaloids