Int. Adv. Otol. 2009; 5(3); 346-356

Platinum-induced ototoxicity in children and adolescents with cancer
Dilek Gunes, Gunay Kirkim, Pinar Demiral, Kamer Mutafoglu Uysal, Bulent Serbetcioglu, Nur Olgun

Dokuz Eylul University Institute of Oncology, Dept. of Pediatric Oncology, Izmir, Turkey. serbetcioglu@gmail.com

Objective: To evaluate hearing impairment in children with cancer who received platinum compounds.

Materials and Methods: There were 149 children who had received platinum-containing chemotherapy (cisplatin, carboplatin
or both), and 62 of them were eligible in terms of medical and audiologic data. These patients were divided into three groups;
cisplatin-only group (30 children), carboplatin-only group (15 children) and cisplatin + carboplatin group (17 children).

Results: Sixty-two patients were analyzed. Audiological assessments included pure tone audiometry, transient oto-acoustic
emissions and auditory brainstem response testing. Medical records were analyzed for patient characteristics, details of
platinum containing treatment, co-administration of other ototoxic drugs as well as head/neck radiotherapy. The median age at
treatment was 9.4 years, and M:F ratio was 0.8. Ototoxicity incidence was 56% in cisplatin-only group (n=30), and 47% in
cisplatin+carboplatin group (n=17). No patients had ototoxicity in carboplatin-only group (n=15). Majority (84%) of patients
having ototoxicity was older than 5 years of age at the initial cancer diagnosis. Of the patients with moderate-severe ototoxicity,
90% was female, and 56% was pubertal/postpubertal girls.

Conclusion: The results of this study is in agreement with previous reports showing that ototoxicity is a potential side effect of
cisplatin, but the standard dose of carboplatin-only usually does not cause ototoxicity. In this study, children older than 5 years
of age and adolescents were also susceptible to develop platinum-induced ototoxicity. Primary tumor site was a risk factor for
ototoxicity in this group of patients. Children with germ cell tumors, particularly the intracranial germ cell tumors tended to
develop ototoxicity more frequently. Collaboration of pediatric oncology and audiology departments is mandatory in order to
monitor platinum induced ototoxicity to avoid further insult and also to rehabilitate when mutilating toxicity occurs.