gms | German Medical Science

4. Dreiländertagung D-A-CH
35. Wissenschaftliche Jahrestagung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie (DGPP)

Deutsche Gesellschaft für Phoniatrie und Pädaudiologie e. V.

20.09. - 23.09.2018, Innsbruck, Österreich

Incidence and course of ototoxic hearing loss in a big European cohort of childhood cancer patients – subproject of PanCareLIFE

Vortrag

  • corresponding author presenting/speaker Amélie Tillmanns - Klinik für Phoniatrie und Pädaudiologie, Universitätsklinikum Münster, Münster, Deutschland
  • author Ross Parfitt - Klinik für Phoniatrie und Pädaudiologie, Universitätsklinikum Münster, Münster, Deutschland
  • author Peter Matulat - Klinik für Phoniatrie und Pädaudiologie, Universitätsklinikum Münster, Münster, Deutschland
  • author Dirk Deuster - Klinik für Phoniatrie und Pädaudiologie, Universitätsklinikum Münster, Münster, Deutschland
  • author Eva Clemens - Department of Pediatric Oncology, Erasmus Medical Center Rotterdam and Princess Maxima Center for Pediatric Oncology Utrecht, Rotterdam, Niederlande
  • Thorsten Langer - Clinic for Pediatric Hematology and Oncology, University Lübeck, Lübeck, Deutschland
  • Stefan Bielack - Department of Pediatric Oncology, Klinikum Stuttgart, Stuttgart, Deutschland
  • Eline van Dulmen-den Broeder - Vrije Universiteit Medical Center, Amsterdam, Niederlande
  • Claudia Kuehni - Institute of Social and Preventive Medicine, University of Bern, Bern, Schweiz
  • Herwig Lackner - Department of Pediatrics and Adolescent Medicine, Division of Pediatric Haematology/Oncology, Medical University of Graz, Graz, Österreich
  • Tomas Kepak - Department of Pediatric Oncology, University of Brno, Czech Republic, Brno, Tschechische Republik
  • Jarmila Kruseova - Department of Pediatric Oncology, University Hospital Motol, Prague, Prague, Tschechische Republik
  • Riccardo Haupt - Servizio di Epidemiologia e Biostatistica, Istituto Giannina Gaslini, Genua, Italien
  • Jeanette Falck-Winther - Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark, Copenhagen, Dänemark
  • Leontien Kremer - Academic Medical Center, Amsterdam, Amsterdam, Niederlande
  • Gabriele Calaminus - Department of Pediatric Hematology and Oncology, University Children’s Hospital, Bonn, Deutschland
  • Linda Broer - Department of Pediatric Oncology, Erasmus Medical Center Rotterdam and Princess Maxima Center for Pediatric Oncology Utrecht, Rotterdam, Niederlande
  • Andre Uitterlinden - Department of Pediatric Oncology, Erasmus Medical Center Rotterdam and Princess Maxima Center for Pediatric Oncology Utrecht, Rotterdam, Niederlande
  • Oliver Zolk - Institut für Naturheilkunde & Klinische Pharmakologie, Universitätsklinikum Ulm, Ulm, Deutschland
  • Marry Van den Heuvel-Eibrink - Department of Pediatric Oncology, Erasmus Medical Center Rotterdam and Princess Maxima Center for Pediatric Oncology Utrecht, Rotterdam, Niederlande
  • Julianne Byrne - Boyne Research Institute, Drogheda, Irland
  • Peter Kaatsch - Deutsches Kinderkrebsregister, Johannes Gutenberg Universität Mainz, Mainz, Deutschland
  • Antoinette am Zehnhoff-Dinnesen - Klinik für Phoniatrie und Pädaudiologie, Universitätsklinikum Münster, Münster, Deutschland

Deutsche Gesellschaft für Phoniatrie und Pädaudiologie. Sektion Phoniatrie der Österreichischen Gesellschaft für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie. Schweizerische Gesellschaft für Phoniatrie. 4. Dreiländertagung D-A-CH, 35. Wissenschaftliche Jahrestagung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie (DGPP). Innsbruck, Österreich, 20.-23.09.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV27

doi: 10.3205/18dgpp37, urn:nbn:de:0183-18dgpp374

Veröffentlicht: 14. September 2018

© 2018 Tillmanns et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Abstract

Background: Ototoxicity is a common side effect after platin chemotherapy and existing studies are limited due to small cohorts and a variety of confounding factors (Grewal et al. [1] , Langer et al. [2]). Therefore, studies that enrolled greater numbers of patients will help us to learn more about incidence and course of ototoxic hearing loss, clinical and genetic risk factors.

Material and Methods: In the PanCare LIFE Project, data were collected about chemotherapy, radiation, other ototoxic medicaments and audiological follow-up from a number of European centers to create a cohort of childhood cancer patients who were treated with platin chemotherapy. The audiological tests of 2525 patients were evaluated by the Clinic for Phoniatrics and Pedaudiology at the University Hospital Münster as an audiological reference center and the hearing loss severity was classified according to the Muenster and the SIOP schemes (Schmidt et al. [3], Brock et al. [4]). The hearing loss course of all patients with sufficient audiological tests was analyzed by two pedaudiologists separately. Patients were assigned to the following phenotype groups: no hearing impairment (</= Muenster 1); progression of hearing impairment during chemotherapy; early onset of hearing impairment (>0 (Muenster classification) after 2nd/before 3rd cycle); hearing loss ≥2b (Muenster classification) on at least one ear at end of chemotherapy; progression of hearing impairment after end of chemotherapy.

Results: Phenotyping was possible in 513 patients. In total, 234 patients had no hearing loss during the whole observation period. During therapy, 263 patients suffered from a progressive hearing loss. Of these, 83 had an early onset hearing loss and 182 developed a hearing loss ≥2b (Muenster classification) at the post-treatment evaluation. A progression of hearing loss later than 15 months after the end of therapy could be observed in 52 cases. Odds ratios between early onset hearing loss, severe hearing loss at the end of chemotherapy and posttherapeutic progression will be presented with detailed information on extent, rate and time course of hearing loss progression.

Discussion: These data are the first preliminary results from a big European cohort of childhood cancer patients treated with platin chemotherapy, providing information about incidence and course of hearing loss in one of the biggest studies existing up to now. The predefined audiological phenotypes are discussed on the basis of different degrees and time courses of hearing loss progression.


Text

Background

Ototoxicity is a common side effect after platin chemotherapy and existing studies are limited due to small cohorts and a variety of confounding factors [1], [2]. Therefore, studies that enrolled greater numbers of patients will help us to learn more about incidence and course of ototoxic hearing loss, clinical and genetic risk factors.

Material and Methods

In the PanCare LIFE Project, data were collected about chemotherapy, radiation, other ototoxic medicaments and audiological follow-up from a number of European centers to create a cohort of childhood cancer patients who were treated with platin chemotherapy. The audiological tests of 2525 patients were evaluated by the Clinic for Phoniatrics and Pedaudiology at the University Hospital Münster as an audiological reference center and the hearing loss severity was classified according to the Muenster and the SIOP schemes [3], [4]. The hearing loss course of all patients with sufficient audiological tests was analyzed by two pedaudiologists separately. Patients were assigned to the following phenotype groups: no hearing impairment (</= Muenster 1); progression of hearing impairment during chemotherapy; early onset of hearing impairment (>0 Muenster classification after 2nd/before 3rd cycle); hearing loss ≥2b Muenster classification on at least one ear at end of chemotherapy; progression of hearing impairment after end of chemotherapy. Patients from the whole cohort were included for phenotype assessment in the following conditions: Patients fulfilled the study inclusion criteria (<18 years of age at diagnosis, chemotherapy with cisplatin and/or carboplatin, written informed consent) and had at least one audiogram at all. Phenotyping was defined to be possible in all cases with a normal audiogram before treatment or at some time during early treatment, and with a post treatment audiogram at any time ≤15 months after the end of treatment.

Results

Phenotyping was possible in 513 patients. In total, 234 patients had no relevant hearing loss (≤ Muenster classification 1) during the whole observation period. During therapy, 263 patients suffered from a progressive hearing loss. Of these, 83 had an early onset hearing loss and 182 developed a hearing loss ≥2b (Muenster classification) at the post-treatment evaluation. A progression of hearing loss later than 15 months after the end of therapy could be observed in 52 cases. Odds ratios between early onset hearing loss, severe hearing loss at the end of chemotherapy and posttherapeutic progression will be presented with detailed information on extent, rate and time course of hearing loss progression.

Discussion

These data are the first preliminary results from a big European cohort of childhood cancer patients treated with platin chemotherapy, providing information about incidence and course of hearing loss in one of the biggest studies existing up to now. The predefined audiological phenotypes are discussed on the basis of different degrees and time courses of hearing loss progression.


References

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Langer T, am Zehnhoff-Dinnesen A, Radtke S, Meitert J, Zolk O. Understanding platinum-induced ototoxicity. Trends Pharmacol Sci. 2013 Aug;34(8):458-69. DOI: 10.1016/j.tips.2013.05.006 Externer Link
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