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Original Article

Long term hearing degeneration after platinum-based chemotherapy in childhood

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Pages 765-771 | Received 23 Jun 2009, Accepted 09 Apr 2010, Published online: 27 Sep 2010
 

Abstract

Abstract

The aim of this study was to investigate long-term development of hearing in subjects who had received platinum-based chemotherapy in childhood or adolescence. Another aim was to assess the self-reported hearing loss handicap and compare it to audiometric measurements. Medical records from individuals diagnosed with childhood cancer and treated with platinum-based chemotherapy between 1985 and 2000 at the University Hospital in Lund Sweden were reviewed retrospectively. Fifteen subjects, who fulfilled the eligibility criteria set for the study, underwent a thorough audiometric evaluation. The results show that the hearing loss, in subjects with ototoxicity had increased after the end of treatment, to include also the lower frequencies. The largest deterioration in hearing thresholds, up to 55 dB HL, was found at frequencies above 2 kHz. The findings also reveal that the subjects have a considerably greater hearing loss handicap and disability than would be expected from the results of the audiometric evaluations. The conclusion of this study is that children and adolescence treated with platinum-based chemotherapy should have regular audiometric follow-up examinations, also many years after the end of treatment. Furthermore, assessments of self-reported hearing disability should be made during and after chemotherapy.

Sumario

El objetivo de este estudio fue investigar el desarrollo de la audición a largo plazo en sujetos que recibieron quimioterapia de platino en la niñez o en la adolescencia. Otro objetivo fue evaluar los auto-reportes de discapacidad por la pérdida auditiva y compararlos con las mediciones audiométricas. Se revisaron retrospectivamente los expedientes médicos de individuos diagnosticados con cáncer en la niñez y tratados con quimioterapia con platino entre 1985 y 2000, en el Hospital Universitario de Lund, Suecia. Quince sujetos que cubrieron los criterios de elegibilidad para el estudio, se sometieron a una evaluación audiométrica minuciosa. Los resultados mostraron que la pérdida auditiva en sujetos con ototoxicidad aumentó después de terminar el tratamiento, incluyendo también las frecuencias graves. La mayor pérdida en los umbrales auditivos, hasta de 55 dB HL, se encontró en las frecuencias superiores a 2 kHz. Los hallazgos revelan también que los sujetos presentan una discapacidad y una desventaja auditiva considerablemente mayor que lo que podría esperarse a partir de los resultados de las evaluaciones audiométricas. La conclusión de este estudio es que los niños y adolescentes tratados con quimioterapia con platino deben ser sometidos a un seguimiento en las evaluaciones audiométricas, incluso muchos años después de terminar el tratamiento. Más aún, las evaluaciones de los auto-reportes sobre discapacidad auditiva, deben practicarse durante y después de la quimioterapia.

Acknowledgement

The present study was supported by a grant from the Margit Arstrups fund at the University Hospital in Lund, Sweden, and GN Otometrics in Denmark.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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