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. 2012 Apr 1;30(10):1034-41.
doi: 10.1200/JCO.2011.36.9744. Epub 2012 Feb 27.

Carboplatin-associated ototoxicity in children with retinoblastoma

Ibrahim Qaddoumi  1 , Johnnie K Bass, Jianrong Wu, Catherine A Billups, Amy W Wozniak, Thomas E Merchant, Barrett G Haik, Matthew W Wilson, Carlos Rodriguez-Galindo
Affiliations

Carboplatin-associated ototoxicity in children with retinoblastoma

Ibrahim Qaddoumi et al. J Clin Oncol. .

Abstract

Purpose: Carboplatin-induced ototoxicity remains poorly defined but is of potential great consequence in children with retinoblastoma. We retrospectively assessed the incidence of ototoxicity and its risk factors in children with retinoblastoma who were treated with carboplatin.

Patients and methods: We reviewed the audiologic test results of 60 patients with retinoblastoma who received front-line treatment with systemic carboplatin and vincristine according to the St Jude RET-3 protocol (n = 23) or best clinical management (n = 37). Ototoxicity was evaluated by three different grading systems.

Results: Twelve patients (20%) developed ototoxicity at some time after treatment initiation; however, ototoxicity resolved in two patients, and thus,10 patients (17%) had sustained hearing loss as documented at their most recent audiologic evaluation. Nine of these 10 patients had grade 3 or 4 ototoxicity, and nine patients were less than 6 months of age at the start of chemotherapy. Age at the start of chemotherapy was the only risk factor identified as a significant predictor of sustained hearing loss. Younger age was associated with an increased incidence of hearing loss. The different ototoxicity grading systems showed good overall agreement in the identification of patients with ototoxicity. Agreement was greatest between the Brock and Children's Cancer Group systems.

Conclusion: We found that young patients with retinoblastoma who were treated with systemic carboplatin had a higher incidence of ototoxicity than previously reported. Younger patients (< 6 months of age at the start of treatment) were more likely to have ototoxicity than were older patients. Children treated with carboplatin should routinely undergo thorough, long-term audiologic monitoring.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
(A) Cumulative incidence of hearing loss in all patients. (B) Cumulative incidence of hearing loss by age at treatment initiation (< 6 months [n = 24] v ≥ 6 months [n = 37]; P = .004).
Fig 2.
Fig 2.
Scatter plot of age at treatment initiation and cumulative carboplatin dose.
See this image and copyright information in PMC

Comment in

References

    1. Rodriguez-Galindo C, Wilson MW, Haik BG, et al. Treatment of intraocular retinoblastoma with vincristine and carboplatin. J Clin Oncol. 2003;21:2019–2025. - PubMed
    1. Jehanne M, Lumbroso-Le Rouic L, Savignoni A, et al. Analysis of ototoxicity in young children receiving carboplatin in the context of conservative management of unilateral or bilateral retinoblastoma. Pediatr Blood Cancer. 2009;52:637–643. - PubMed
    1. Lambert MP, Shields C, Meadows AT. A retrospective review of hearing in children with retinoblastoma treated with carboplatin-based chemotherapy. Pediatr Blood Cancer. 2008;50:223–226. - PubMed
    1. Smits C, Swen SJ, Theo Goverts S, et al. Assessment of hearing in very young children receiving carboplatin for retinoblastoma. Eur J Cancer. 2006;42:492–500. - PubMed
    1. Friedman DL, Himelstein B, Shields CL, et al. Chemoreduction and local ophthalmic therapy for intraocular retinoblastoma. J Clin Oncol. 2000;18:12–17. - PubMed

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