Artikel
Platin treatment and hearing loss: initial audiological results from PanCareLIFE
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Veröffentlicht: | 13. September 2019 |
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Gliederung
Abstract
Background: Cisplatin and carboplatin are widely used in paediatric cancer treatment. Cisplatin especially can have long-term side effects, including sensorineural hearing loss. The aim of this study is to define the risk factors for platin-related ototoxicity.
Materials and Methods: As part of the PanCareLIFE consortium, we gathered audiological data from 13 pan-European clinics. Eligible patients were <18 years old at diagnosis, underwent treatment with cisplatin or carboplatin and had no evidence of pre-treatment hearing loss (>20 dB HL at any frequency).
A total of 2,696 patients with 10,320 audiograms from various stages of cancer treatment were obtained. Audiometric data were quality-checked and classified (Münster and SIOP classifications) and 736 patients with sufficient data were phenotyped. A logistic regression investigated the likelihood of developing a hearing loss ≥Münster 2b (thresholds >40 dB HL at ≥4 kHz) after treatment given age, gender, cisplatin dose and cranial irradiation.
Results: 48.2% of 1,385 patients with a post-treatment audiogram had clinically-relevant hearing loss (defined as ≥Münster 2b) after platin treatment.
Children <5 years old were more likely to develop hearing loss than those >15 years (odds ratio 2.7, 95% CI 1.5–4.9, p=0.0006). Patients with a cumulative cisplatin dose >450 mg/m2 were more likely to develop hearing loss than those treated with carboplatin alone (OR 12.5, 95% CI 6.8–23.0, p=3.7x10–16). Treatment with cranial irradiation was more likely to lead to hearing loss than without (OR 4.5, 95% CI 3.0–6.7, p=7.2x10–13).
Discussion: This is the first study of platin ototoxicity with such a large sample size. The results support tendencies found in previous studies with smaller groups. The high risk groups identified here must be monitored regularly for ototoxicity. Further detailed analyses into audiological changes and possible pharmacogenetic confounders are planned.
Conclusion: 48% of patients treated with cisplatin develop clinically-relevant hearing loss. Age <5 years old, higher cumulative cisplatin doses and cranial irradiation present especially high risks.
Acknowledgement: This work was supported by the PanCareLIFE consortium that has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no. 602030.
Text
Background
Cisplatin and carboplatin are widely used in paediatric cancer treatment. Cisplatin especially can have long-term side effects, including sensorineural hearing loss. The aim of this study is to define the risk factors for platin-related ototoxicity.
Materials and Methods
As part of the PanCareLIFE consortium, we gathered audiological data from 13 pan-European clinics. Eligible patients were <18 years old at diagnosis, underwent treatment with cisplatin or carboplatin and had no evidence of pre-treatment hearing loss (>20 dB HL at any frequency).
A total of 2,696 patients with 10,320 audiograms from various stages of cancer treatment were obtained. Audiometric data were quality-checked and classified (Münster and SIOP classifications) and 736 patients with sufficient data were phenotyped. A logistic regression investigated the likelihood of developing a hearing loss ≥Münster 2b (thresholds >40 dB HL at ≥4 kHz) after treatment given age, gender, cisplatin dose and cranial irradiation.
Results
48.2% of 1,385 patients with a post-treatment audiogram had clinically-relevant hearing loss (defined as ≥Münster 2b) after platin treatment.
Children <5 years old were more likely to develop hearing loss than those >15 years (odds ratio 2.7, 95% CI 1.5–4.9, p=0.0006). Patients with a cumulative cisplatin dose >450 mg/m2 were more likely to develop hearing loss than those treated with carboplatin alone (OR 12.5, 95% CI 6.8–23.0, p=3.7x10–16). Treatment with cranial irradiation was more likely to lead to hearing loss than without (OR 4.5, 95% CI 3.0–6.7, p=7.2x10–13).
Discussion
This is the first study of platin ototoxicity with such a large sample size. The results support tendencies found in previous studies with smaller groups. The high risk groups identified here must be monitored regularly for ototoxicity. Further detailed analyses into audiological changes and possible pharmacogenetic confounders are planned.
Conclusion
48% of patients treated with cisplatin develop clinically-relevant hearing loss. Age <5 years old, higher cumulative cisplatin doses and cranial irradiation present especially high risks.
Acknowledgement: This work was supported by the PanCareLIFE consortium that has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no. 602030.