Early and Long-Term Ototoxicity Noted in Children Due to Platinum Compounds: Prevalence and Risk Factors

Abstract

Background: Platinum compounds are a group of fundamental chemotherapeutics used in the treatment of solid tumors, but they are burdened by side effects, such as ototoxicity. The objective of this study was to evaluate the incidence of ototoxicity caused by platinum compounds and the risk factors affecting its appearance/progression. Methods: Data from 53 patients who received platinum compounds and who had been off therapy for at least 5 years were analyzed. We collected data relating to audiometry conducted annually from the end of treatment and for at least 5 subsequent years, as well as information concerning the oncological history and comorbidities. Results: At the end of the treatment, 17 patients (32.08%) presented ototoxicity, according to the Boston SIOP Ototoxicity Scale; the risk factors included a higher serum creatinine value at diagnosis, having undergone cranial radiotherapy, and needing magnesium supplementation. After 5 years from the end of the treatment, the number of patients with exhibiting ototoxicity was 31 (58.5%); the factors that influenced the onset/progression of the damage were having undergone radiotherapy (HR 1.23; p < 0.01) and having received therapy with aminoglycosides (HR 1.27; p < 0.01). Conclusions: Ototoxicity caused by platinum compounds can occur even after the conclusion of the treatments, and the factors affecting its progression are radiotherapy and the aminoglycosides therapy.

A Rare Case of Unilateral Auditory Neuropathy Induced by Proton Therapy

“…HL is symmetric, bilateral, and sensorineural and affects first the higher frequencies (above 6,000 Hz). The deficit persists and, although it primarily manifests during treatment, HL can occasionally occur after chemotherapy discontinuation [ 2 , 7 , 8 ]. The risk of PBC-associated SNHL is further increased when oncological treatment requires its combination with XRT [ 9 ].…”

“…Hearing loss (HL) is a common complication of cancer treatments, particularly in head and neck malignancies. They generally stem from a direct impact on the sensory cells of the Corti's organ, caused by the use of platinum-based chemotherapy (PBC) and resulting in an irreversible bilateral high-frequency sensorineural hearing loss (SNHL) [ 1 , 2 ]. Conversely, auditory neuropathy spectrum disorder (ANSD, a diverse set of impairments that may affect different auditory structures from inner hair cells to auditory nuclei) is rarely associated with anticancer treatments.…”

Aminoglycosides-Related Ototoxicity: Mechanisms, Risk Factors, and Prevention in Pediatric Patients

“…Cisplatin is the most ototoxic agent. Its toxicity is greater for higher cumulative doses, for younger ages (the highest risk is for children under five years of age), for bolus infusion, than short infusion [121,122]. The synergic toxic effects of aminoglycosides and cisplatin have been reported in animal studies; combined cisplatin and gentamicin administration in guinea pigs enhanced ototoxic effect when cisplatin was given early in a 14-day gentamicin course [123].…”