Recent News and Articles on the Keywords: hearing + loss + chemotherapy  Related to the article below (Last Update: 8/7/2008)

Hearing loss from chemotherapy underestimated

A study published in the Journal of Clinical Oncology found that the frequency and severity of ototoxicity from the chemotherapy ( Carboplatin, Cisplatin ), as well as its long-term effects on development, have long been underreported by the medical community.

The research found that a well-known classification system doctors use for reporting toxicities in patients, the National Cancer Institute's Common Terminology Criteria for Adverse Events, or CTCAE, doesn't consider high-frequency hearing loss, allowing the magnitude of ototoxicity in children treated with platinum agents to be miscalculated.

The purpose of the study is "to make people aware that this is more common than people think and we need to follow this issue," said Kristy Gilmer Knight, at OHSU's Doernbecher Children's Hospital and the study's lead author.

Knight said a major problem for doctors trying to diagnose hearing loss from ototoxicity is that it's not that obvious. " The way it manifests itself is not that children lose all their hearing," she said. " The way it manifests itself is tricky. The typical presentation is high-frequency hearing loss, and so it may not look like they're having a problem, especially when communicating one-on-one in a quiet room. And kids won't complain about not understanding what was said when they're really little."

And that can lead to development issues for children. A 1998 study that evaluated the educational performance and social-emotional functioning of about 1,200 children with minimal hearing loss found that 37 percent failed at least one grade in school compared with the normal rate of 3 percent. They also had more problems with behavior, energy, stress, self-esteem and social support.

OHSU researchers tested the hearing of 67 patients, ages 8 months to 23 years, who received platinum-based chemotherapy. Data was analyzed to determine the length of time to hearing loss using criteria from the American Speech-Language-Hearing Association, or ASHA, and the effects of treatment and patient characteristics on the incidence and severity of ototoxicity.

According to the study, hearing loss was found in 61 percent of patients, with average onset beginning 135 days after chemotherapy.
This included 55 percent of children treated with cisplatin; 38 percent of children treated with Cisplatin's less-toxic derivative, Carboplatin; and 84 percent of children treated with both agents.