Prospective evaluation of cisplatin- and carboplatin‑mediated ototoxicity in paediatric and adult soft tissue and osteosarcoma patients

Nitz,Alexandra; Kontopantelis,Evangelos; Bielack,Stefan; Koscielniak,Ewa; Klingebiel,Thomas; Langer,Thorsten; Paulides,Marios

doi:10.3892/ol.2012.997

Prospective evaluation of cisplatin- and carboplatin‑mediated ototoxicity in paediatric and adult soft tissue and osteosarcoma patients

Authors:
- Alexandra Nitz
- Evangelos Kontopantelis
- Stefan Bielack
- Ewa Koscielniak
- Thomas Klingebiel
- Thorsten Langer
- Marios Paulides
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Affiliations: Department of Paediatric Oncology and Immunology, LESS Centre, University Hospital for Children and Adolescents, Erlangen D-91054, Germany, Department of Community Based Medicine (Health Sciences Research Group - Primary Care), University of Manchester, M13 9PL, UK, Department of Oncology, Haematology, Immunology, General Pediatrics, Gastroenterology, Rheumatology (COSS Study), Klinikum Stuttgart - Olgahospital, Stuttgart D-70176, Germany, Department of Oncology, Haematology, Immunology, General Pediatrics, Gastroenterology, and Rheumatology (CWS study), Klinikum Stuttgart - Olgahospital, Stuttgart D-70176, Germany , Department of Paediatric Haematology, Oncology and Haemostaseology, Universitaetsklinikum Frankfurt - Johann-Wolfgang-Goethe-University, Frankfurt D-60596, Germany
Published online on: October 25, 2012 https://doi.org/10.3892/ol.2012.997
Pages: 311-315

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Abstract

Platinum-compound chemotherapy is known to have ototoxic side-effects. However, there is a paucity of literature examining hearing function prospectively and longitudinally in cohorts containing paediatric and adult patients treated within the same cisplatin- or carboplatin‑containing treatment trial protocols. In Germany, Austria and Switzerland, late effects of treatment for osteosarcoma and soft tissue sarcoma have been prospectively and longitudinally registered by the Late Effects Surveillance System since 1998. The aim of this study was to analyse cisplatin- and carboplatin-induced ototoxity in a group of 129 osteosarcoma and soft tissue sarcoma patients treated within the COSS-96, CWS-96 and CWS-2002P treatment trials. The cohort consisted of 112 children and 17 adults. The median age at diagnosis was 13.56 (IQR, 10.26‑16.27) years. Follow-up was 6.97 (IQR, 0.87‑15.63) months. Hearing function was examined by audiometry before and after platinum treatment. A total of 108 patients were treated with cisplatin with a median cumulative dose of 360 mg/m2. Thirteen patients received carboplatin with a median cumulative dose of 1500 mg/m2 and 8 patients were treated with both platinum compounds (median cisplatin dose, 240 mg/m2; IQR, 240-360 mg/m2 and median carboplatin dose: 1200 mg/m2; IQR, 600-3000 mg/m2). Following cessation of therapy, 47.3% of the patients demonstrated a hearing impairment, namely 55 children (49.1%) and 6 adults (42.1%). Out of thirteen children treated with carboplatin with a cumulative dose of 1500 mg/m2, six revealed a significant hearing impairment. Although ototoxicity caused by platinum compounds is considered irreversible, we identified hearing improvements over time in 11 children (9.8%) and 3 adults (17.6%). None of these patients received irradiation to the head. We conclude that hearing loss is frequent in children treated with protocols containing platinum compounds and recommend prospective testing via audiometry.

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