Article

Cisplatin ototoxicity in children: A practical grading system

  1. Penelope R. Brock MD1,†,*,
  2. Susan C. Bellman CB, DLO, FRCS MD2,
  3. Elizabeth C. Yeomans SRN1,
  4. C. Ross Pinkerton MD,FRCPI3,
  5. Jon Pritchard FRCP1

Article first published online: 20 JUL 2006

DOI: 10.1002/mpo.2950190415

Issue

Medical and Pediatric Oncology

Medical and Pediatric Oncology

Volume 19, Issue 4, pages 295–300, 1991

Additional Information

How to Cite

Brock, P. R., Bellman, S. C., Yeomans, E. C., Pinkerton, C. R. and Pritchard, J. (1991), Cisplatin ototoxicity in children: A practical grading system. Med. Pediatr. Oncol., 19: 295–300. doi: 10.1002/mpo.2950190415

Author Information

  1. 1

    Department of Haematology and Oncology, The Hospitals for Sick Children, London

  2. 2

    Department of Audiological Medicine, The Hospitals for Sick Children, London

  3. 3

    Department of Paediatric Oncology, The Royal Marsden Hospital, Sutton Surrey, England

  1. †

    Department of Paediatrics, University of Leuven, 49, Herestraat, 3000 Leuven, Belgium

*Department of Paediatrics, University of Leuven, 49, Herestraat, 3000 Leuven, Belgium

Publication History

  1. Issue published online: 20 JUL 2006
  2. Article first published online: 20 JUL 2006
  3. Manuscript Accepted: 14 FEB 1991
  4. Manuscript Received: 7 MAY 1990

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Keywords:

  • cisplatin;
  • ototoxicity;
  • high-frequency hearing loss;
  • young children

Abstract

A long-term follow-up study was carried out to assess ototoxicity in children who had been treated for a malignant tumour with “standard dose” cisplatin (60–;100 mg/m2 per course), and were at least 2 years from stopping treatment. The median age at diagnosis was 2 years 2 months (range 1 month to 13.5 years). On the basis of hearing assessment by pure-tone audiometry, a practical grading system of hearing loss from 0 to 4 is proposed. Moderate to severe high-frequency hearing loss (grade 2–4) was found in half the children and 10 require appropriate hearing aids. The risk of developing ototoxicity increased significantly with the cumulative cisplatin dose (P = 0.027), although there was considerable individual susceptibility. Serial follow-up testing, to a median of 4 years after completion of cisplatin treatment, showed no recovery of hearing in any of these children. We suggest careful monitoring of young children by a consultant audiological physician, throughout treatment with cisplatin, particularly when doses of 400 mg/m2 and over have been reached. Alternative chemotherapy should be discussed if grade 2 ototoxicity develops.

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