Adverse Factors and the Role of Cisplatin and Vinca Alkaloids for Hearing Impairment in Childhood Cancer Patients and Survivors
10.15264/cpho.2017.24.2.121
- Author:
Min Woo HUR
1
;
Seung Min HAHN
;
In Seok MOON
;
Ju Yeon LIM
;
Seul Mi LEE
;
Chuhl Joo LYU
;
Jung Woo HAN
Author Information
1. Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea. jwhan@yuhs.ac
- Publication Type:Original Article
- Keywords:
Survivors;
Hearing loss;
Neoplasms;
Cisplatin;
Vinca alkaloids
- MeSH:
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
- From:Clinical Pediatric Hematology-Oncology
2017;24(2):121-129
- CountryRepublic of Korea
- Language:English
-
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.
