Risk factors associated with tinnitus in 2948 Dutch survivors of childhood cancer: a Dutch LATER questionnaire study

Abstract

Background Tinnitus is a serious late effect of childhood cancer treatment. The aim of this study was to determine the occurrence and risk factors for tinnitus in a national cohort of childhood cancer survivors (CCS). Methods Data were collected within the national DCOG-LATER cohort by a self-reported health questionnaire among 5,327 Dutch CCS treated between 1963-2002. Siblings (N=1,663) were invited to complete the same questionnaire. Relevant patient characteristics and treatment factors were obtained from the Dutch LATER database. Occurrence of tinnitus in survivors was compared to siblings. To study the effect of risk factors, multivariate logistic regression models were estimated. Results In total, 2,948 CCS and 1,055 siblings completed the tinnitus item. Tinnitus was reported in 9.5% of survivors and in 3.7% of siblings (OR 3.0, 95% CI 2.9-3.1). Risk factors associated with tinnitus in CCS were total cumulative dose cisplatin ≥400 mg/m 2 (OR 2.4, 95% CI 1.4-4.0), age at diagnosis (≥10 years: OR 2.1, 95% CI 1.6-2.8), cranial irradiation/total body irradiation (TBI) (OR 1.9, 95% CI 1.5-2.5), and neuro/ear, nose, throat (ENT) surgery (OR 1.8, 95% CI 1.1-2.9). Fifty-one percent of CCS with tinnitus had received treatment with either cisplatin, cranial irradiation/TBI, and/or neuro/ENT surgery. Conclusions Tinnitus in CCS was present nearly three times more often than in siblings. Awareness in CCS previously treated with cisplatin, cranial irradiation/TBI and/or neuro/ENT surgery is warranted. As only half of affected CCS had a history of these treatments, it seems that other factors might be associated with tinnitus occurrence in this population.

Questionnaire‐ and linkage‐based outcomes in Dutch childhood cancer survivors: Methodology of the DCCSS LATER study part 1

“…Until present, 35 published reports from national and international collaborative studies include data from the LATER 1 study, 6 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 addressing cardiac outcomes, 20 , 21 , 22 , 23 subsequent tumors, 6 , 14 , 15 , 19 , 24 , 25 , 26 , 29 , 33 , 34 , 35 , 42 , 44 , 45 burden of disease, 31 , 32 mort...…”

Auditory Complications among Childhood Cancer Survivors and Health-related Quality of Life: A PanCareLIFE study

“…The higher prevalence is possibly explained by previously identified risk factors for tinnitus among CCS, such as exposure to cisplatin, CRT, and CNS surgeries. 4 In Meijer and colleagues' systematic review, the prevalence of tinnitus ranged from 3-17%. 2 They also recently published a population-based study where they estimated the prevalence of tinnitus to be 9.5% among CCS compared with 3.7% for siblings.…”

“…1,2 In recent surveys, childhood cancer survivors (CCS) reported more hearing loss and tinnitus when compared with their siblings. 3,4 Ototoxic cancer treatments include platinum-based chemotherapy, cranial radiotherapy (CRT), and surgeries involving the auditory system. 1,4,5 Other suspected ototoxic treatments are concomitant medications such as aminoglycosides or loop diuretics, hematopoietic stem cell transplantation (HSCT), or the neurotoxic vinca alkaloid vincristine.…”

“…3,4 Ototoxic cancer treatments include platinum-based chemotherapy, cranial radiotherapy (CRT), and surgeries involving the auditory system. 1,4,5 Other suspected ototoxic treatments are concomitant medications such as aminoglycosides or loop diuretics, hematopoietic stem cell transplantation (HSCT), or the neurotoxic vinca alkaloid vincristine. [5][6][7] Hearing loss and tinnitus lead to a wide range of educational and psychosocial problems such as learning difficulties and emotional distress among CCS and the general population.…”

“…Several studies examined the prevalence of hearing loss among CCS treated with cisplatin or CRT, yet studies of the overall population-and studies investigating tinnitus-are scarce. 3,4,15,16 We thus combined harmonized data from four European countries into a large cohort of CCS to describe the prevalence of hearing loss and tinnitus and investigate their association with HRQoL.…”