Chemo-related hearing loss a problem for kids

By Will Boggs, MD

NEW YORK (Reuters Health) – Hearing loss may be more common
than previously reported in children with cancer who have
undergone chemotherapy with highly effective platinum-type
drugs such as cisplatin and carboplatin, researchers report.

“As pediatric patients experience improved survival, the
effect and implications of high-frequency hearing loss with
regard to academic achievement and speech and language
development are important considerations, especially in
patients younger than five years,” they write in a report in
the Journal of Clinical Oncology.

“The key is doing standard audiometry (hearing tests)
before each dose of platinum,” Dr. Edward A. Neuwelt from
Oregon Health and Science University, Portland, Oregon told
Reuters Health.

Neuwelt and colleagues examined the incidence of and time
to hearing loss in 67 patients aged 8 months to 23 years who
received platinum-based chemotherapy.

Forty-one of the 67 patients (61 percent) experienced a
decrease in hearing sensitivity after chemotherapy, the authors
report, including 55 percent of children treated with
cisplatin, 38 percent of children treated with carboplatin, and
84 percent of children treated with both agents.

Hearing loss was more severe among children who received
chemotherapy for medulloblastoma (a type of brain tumor),
osteosarcoma (a type of bone cancer), and neuroblastoma (cancer
of developing nerve cells in the fetus), the researchers note,
and males had higher-grade hearing loss than females.

After an average follow-up of 20.7 months, none of the
patients experienced an improvement in hearing. Three patients
had mild progression of their hearing loss, the report
indicates, and all three had been treated with cranial
radiation followed by cisplatin for medulloblastoma.

SOURCE: Journal of Clinical Oncology December 1, 2005.