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Ototoxicity in children with high-risk neuroblastoma: prevalence, risk factors, and concordance of grading scales--a report from the Children's Oncology Group.

Publication ,  Journal Article
Landier, W; Knight, K; Wong, FL; Lee, J; Thomas, O; Kim, H; Kreissman, SG; Schmidt, ML; Chen, L; London, WB; Gurney, JG; Bhatia, S
Published in: J Clin Oncol
February 20, 2014

PURPOSE: Platinum-based therapy is the mainstay for management of high-risk neuroblastoma. Prevalence of platinum-related ototoxicity has ranged from 13% to 95% in previous reports; variability is attributable to small samples and disparate grading scales. There is no consensus regarding optimal ototoxicity grading. Furthermore, prevalence and predictors of hearing loss in a large uniformly treated high-risk neuroblastoma population are unknown. We address these gaps in our study. PATIENTS AND METHODS: Audiologic testing was completed after administration of cisplatin alone (< 400 mg/m(2); exposure one) or after cisplatin (400 mg/m(2)) plus carboplatin (1,700 mg/m(2); exposure two). Hearing loss was graded using four scales (American Speech-Language-Hearing Association; Brock; Chang; and Common Terminology Criteria for Adverse Events, version 3 [CTCAEv3]). RESULTS: Of 489 eligible patients, 333 had evaluable audiologic data. Median age at diagnosis was 3.3 years. Prevalence of severe hearing loss differed by scale. For those in the exposure-one group, prevalence ranged from 8% per Brock to 47% per CTCAEv3 (Brock v CTCAEv3 and Chang, P < .01; CTCAEv3 v Chang, P = .16); for those in the exposure-two group, prevalence ranged from 30% per Brock to 71% per CTCAEv3 (all pair-wise comparisons, P < .01). In patients requiring hearing aids, hearing loss was graded as severe in 49% (Brock), 91% (Chang), and 100% (CTCAEv3). Risk factors for severe hearing loss included exposure to cisplatin and carboplatin compared with cisplatin alone and hospitalization for infection. CONCLUSION: Severe hearing loss is prevalent among children with high-risk neuroblastoma. Exposure to cisplatin combined with myeloablative carboplatin significantly increases risk. The Brock scale underestimates severe hearing loss and should be used with caution in this setting.

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

February 20, 2014

Volume

32

Issue

6

Start / End Page

527 / 534

Location

United States

Related Subject Headings

  • Young Adult
  • Risk Factors
  • Prevalence
  • Oncology & Carcinogenesis
  • Neuroblastoma
  • Neoplasm Grading
  • Male
  • Humans
  • Hearing Loss
  • Female
 

Citation

APA
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MLA
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Landier, W., Knight, K., Wong, F. L., Lee, J., Thomas, O., Kim, H., … Bhatia, S. (2014). Ototoxicity in children with high-risk neuroblastoma: prevalence, risk factors, and concordance of grading scales--a report from the Children's Oncology Group. J Clin Oncol, 32(6), 527–534. https://doi.org/10.1200/JCO.2013.51.2038
Landier, Wendy, Kristin Knight, F Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, Susan G. Kreissman, et al. “Ototoxicity in children with high-risk neuroblastoma: prevalence, risk factors, and concordance of grading scales--a report from the Children's Oncology Group.J Clin Oncol 32, no. 6 (February 20, 2014): 527–34. https://doi.org/10.1200/JCO.2013.51.2038.
Landier, Wendy, et al. “Ototoxicity in children with high-risk neuroblastoma: prevalence, risk factors, and concordance of grading scales--a report from the Children's Oncology Group.J Clin Oncol, vol. 32, no. 6, Feb. 2014, pp. 527–34. Pubmed, doi:10.1200/JCO.2013.51.2038.
Landier W, Knight K, Wong FL, Lee J, Thomas O, Kim H, Kreissman SG, Schmidt ML, Chen L, London WB, Gurney JG, Bhatia S. Ototoxicity in children with high-risk neuroblastoma: prevalence, risk factors, and concordance of grading scales--a report from the Children's Oncology Group. J Clin Oncol. 2014 Feb 20;32(6):527–534.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

February 20, 2014

Volume

32

Issue

6

Start / End Page

527 / 534

Location

United States

Related Subject Headings

  • Young Adult
  • Risk Factors
  • Prevalence
  • Oncology & Carcinogenesis
  • Neuroblastoma
  • Neoplasm Grading
  • Male
  • Humans
  • Hearing Loss
  • Female