Prevalence and risk factors for cisplatin-induced hearing lo
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Cisplatin is used to treat a large variety of childhood cancers and a common and disabling toxicity is cisplatin-induced hearing loss (CIHL). By developing benchmarks for the prevalence of and risk factors for CIHL, researchers aimed to resolve persistent knowledge gaps in CIHL.

In this multi-institutional cohort study, children (age 0–14 years), adolescents, and young adults (age 15–39 years) diagnosed with a cisplatin-treated tumour from paediatric cancer centres, who had available cisplatin dosing information, and primary audiology data for central review were eligible for inclusion.

Researchers assessed the prevalence of moderate or severe CIHL (SIOP grade more than 2) at 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. Whether cisplatin dose reductions and CIHL were associated with survival outcomes was also examined.

--1481 patients who received cisplatin were included .
--Of the 1414 participants who had audiometry at latest follow-up, 620 patients developed moderate or severe CIHL.
--The highest prevalence of CIHL was seen in the youngest patients (aged less than 5 years; 360 of 606 patients) and those with a CNS tumour (221 of 434 patients), hepatoblastoma (110 of 167 patients), or neuroblastoma (154 of 248 patients).
--After accounting for cumulative cisplatin dose, higher fractionated doses were associated with risk for CIHL (for each 10mg/m 2 increase per day, adjusted odds ratio [aOR] 1·15; for each 50 mg/m 2 increase per cycle aOR 2·16).
--Vincristine exposure was newly identified as a risk factor for CIHL (aOR 3·55).
--Dose reductions and moderate or severe CIHL were not significantly associated with survival differences.

Using this broad, multicentre cohort, that benchmarks were developed for the prevalence of CIHL in patients treated with cisplatin. Variations in the dosing of cisplatin impart an additive risk to the production of CIHL and warrant investigation as a possible solution to lower the therapy burden.