@article{TCR2618,
author = {Victoria Castel and Pablo Berlanga},
title = {Ototoxicity: a worrying problem for survivors of high-risk neuroblastoma},
journal = {Translational Cancer Research},
volume = {3},
number = {6},
year = {2014},
keywords = {},
abstract = {Landier et al. report the results of a COG study about ototoxicity in children with neuroblastoma. The authors present the results of audiologic testing graded by four different scales [American Speech-Language-Hearing Association; Brock; Chang; and Common Terminology Criteria for Adverse Events version 3 (CTCAEv3)], in 333/489 evaluable neuroblastoma patients, treated with cisplatin alone (400 mg/m2) or after cisplatin (400 mg/m2) plus carboplatin (1,700 mg/m2) according to COG A3973 protocol. (Their conclusions are that severe hearing loss is prevalent among children with highrisk 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). Hearing loss from cisplatin or carboplatin is permanent and may have a delayed onset, with progressive loss occurring many years after completion of therapy. Young children are particularly sensitive to this adverse effect. Children treated for high-risk neuroblastoma, for example, are likely to sustain moderate to severe therapy-related hearing loss, with high potential for difficulties in speech discrimination and language acquisition, diminished academic achievement compared with peers with normal hearing, the potential for lifelong impairment of language and academic skills, and diminished quality of life. Although often underappreciated, even hearing loss restricted to high frequency ranges (4,000-8,000 Hz) have a significant impact on language development, verbal abilities, and reasoning skills in young children. This is of particular concern because the ototoxic effects are concurrent with the developmental period in which the process of acquiring speech and language skills is so critical. The reported incidence of cisplatin ototoxicity in children ranges from 26% to over 90% with the variation influenced by treatment and patient-related factors, but it also depends to some extent on the grading system used. The absence of a practical and uniform system for grading ototoxicity has impeded assessment of results in prior studies, and another problem is that full compliance with complete audiological testing in these young patients remains a challenge.},
issn = {2219-6803}, url = {https://tcr.amegroups.org/article/view/2618}
}