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ABSTRACT
Cisplatin and carboplatin are effective antineoplastic agents. They are also considered to be potentially highly ototoxic. To date, no long-term follow-up data from well-documented cohorts with substantial numbers of childhood cancer survivors (CCS) with platinum-related hearing loss are available. Therefore, in this study, we studied the reversibility of ototoxicity from discontinuation of treatment onwards in a national cohort of platinum-treated survivors with hearing loss at the end of cancer treatment. Of the 168 CCS with follow-up audiograms, we longitudinally evaluated the course of hearing function in 61 CCS who showed hearing impairment at discontinuation of treatment according to the Münster criteria (>20 dB at ≥4–8 kHz). Survivors were treated with platinum (median total cumulative dose cisplatin: 480 mg/m2 and median total cumulative dose carboplatin: 2520 mg/m2). Median follow-up time was 5.5 years (range: 1.0–28.8 years). The results showed that none of these survivors revealed improvement of hearing function even till 28.8 years after discontinuation of treatment (grade <2b during long-term follow-up). An increase in hearing loss with two or three Münster degrees was observed in five of 61 survivors after 1.6–19.6 years. Overall, this indicates that ototoxicity after platinum treatment may be irreversible and that longitudinal clinical audiological monitoring and care is required in long-term survivors of childhood cancer on a large scale.
Compliance with ethical standards
This study has been submitted by the medical ethical committee and was approved as a non-WMO study (MEC-2015-269) because only data were retrieved from databases and medical records.
Conflicts of interest
The authors declare no conflicts of interest.
Funding
E.C. and S.F.M.P. are supported by the PanCareLIFE project that has received funding from the European Union's Seventh Framework Programme for research, technological development, and demonstration under grant agreement no 602030. A.C.H.d.V. is supported by the Paediatric Oncology Centre Society for Research (KOCR), Rotterdam, the Netherlands.