Chemotherapy induced Hearing loss can be prevented, finds st
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Hearing loss as a potential side effect of chemotherapy is more likely with platinum-based drugs, such as cisplatin or carboplatin. In a recent study, researchers have established the first benchmarks for the prevalence of hearing loss and reported that the risk of hearing loss is affected not only by how much drug is given but, by how that drug delivered-dosing schedules, complementary treatments, and more.

Cisplatin is used to treat a wide range of childhood cancers and cisplatin-induced hearing loss (CIHL) is common and debilitating toxicity. The study aimed to address persistent knowledge gaps in CIHL by establishing benchmarks for the prevalence of and risk factors for CIHL.

In this multi-institutional cohort study, children, adolescents, and young adults diagnosed with a cisplatin-treated tumor were eligible for inclusion. Audiology was centrally reviewed and CIHL graded. They assessed the prevalence of moderate or severe CIHL at the latest follow-up and end of therapy, in each demographic, diagnosis, and treatment group and their relative contributions to risk for CIHL. Secondary endpoints explored associations of cisplatin dose reductions and CIHL with survival. They also examined whether cisplatin dose reductions and CIHL were associated with survival outcomes.

--1481 patients who received cisplatin were included. Of the 1414 participants who had audiometry at the latest follow-up, 620 patients developed moderate or severe CIHL.

--The highest prevalence of CIHL was seen in the youngest patients and those with a CNS tumor, hepatoblastoma, or neuroblastoma.

--After accounting for cumulative cisplatin dose, higher fractionated doses were associated with risk for CIHL.

--Vincristine exposure was newly identified as a risk factor for CIHL. Dose reductions and moderate or severe CIHL were not significantly associated with survival differences.

In particular, benchmarks were established for the prevalence of CIHL in patients treated with cisplatin. Variations in cisplatin dosing confer additive risk for developing CIHL and warrant investigation as a potential approach to decrease the burden of therapy.

The Lancet- Child & Adolescent Health