Study population and study design.
This is a retrospective observational study of children that underwent
5-years long-term hearing monitoring after chemotherapy and that were
selected among 116 children treated with platinum compounds for solid
tumours in our Institution from 2007 to 2014. The inclusion criteria
were: age at the first platinum course ≤18 years, no administration of
other ototoxic drugs, audiological baseline evaluation (within 2 weeks
of the beginning of treatment), audiological monitoring during
chemotherapy (including a re-evaluation prior to each chemotherapy
cycle) and an yearly audiological long-term follow-up for at least 5
years after the end of chemotherapy. Exclusion criteria was a diagnosis
of hearing loss at the baseline evaluation before chemotherapy.
Based on inclusion criteria we enrolled 38 children treated with
platinum compounds and that completed a 5 years long-term follow-up.
Patient’s demographic characteristics, disease status and therapeutic
strategies are summarized in Table 1. Briefly, median age at the
beginning of treatments was 6 (range 1–18), the male-to-female ratio
was 1,375. Most of the primitive lesions were brain tumours (glioma,
medulloblastoma and astrocytoma), but aggressive tumours like
neuroblastomas, osteosarcomas, germ cell tumours and retinoblastomas
were also included.
About treatment modalities:
- Twenty-one patients (55.3%) were treated with cisplatin with or
without radiation therapy, of which 12 (57.1%) switched to
carboplatin because of toxicity onset, with a cisplatin’s median
cumulative dose of 245 mg/sqm (range 40–1080 mg/sqm) and six received
a cumulative dose > 400 mg/sqm;
- Seventeen patients (44.7%) were treated with carboplatin with or
without radiation therapy, with a median cumulative dose of 3400
mg/m2 (range 800–6050 mg/ m2) of
which one received a cumulative dose > 5000 mg/
m2