Background
Ototoxicity is a common adverse event of cisplatin treatment. The authors investigated the development of cisplatin‐induced hearing loss (CIHL) over time in children with cancer by age and ...examined the influence of other clinical characteristics on the course of CIHL.
Methods
Data from Canadian patients with childhood cancer were retrospectively reviewed. Hearing loss was graded according to International Society of Pediatric Oncology criteria. The Kaplan‐Meier method was applied to estimate the cumulative incidence of CIHL for the total cohort and according to age. Cox regression models were used to explore the effects of independent variables on CIHL development up to 3 years after the start of therapy.
Results
In total, 368 patients with 2052 audiological assessments were included. Three years after initiating therapy, the cumulative incidence of CIHL was highest in patients aged ≤5 years (75%; 95% confidence interval CI, 66%‐84%), with a rapid increase observed to 27% (95% CI, 21%‐35%) at 3 months and to 61% (95% CI, 53%‐69%) at 1 year, compared with patients aged >5 years (48%; 95% CI, 37%‐62%; P < .001). The total cumulative dose of cisplatin at 3 months (per 100 mg/m2 increase: hazard ratio HR, 1.20; 95% CI, 1.01‐1.41) vincristine (HR, 2.87; 95% CI, 1.89‐4.36) and the total duration of concomitantly administered antibiotics (>30 days: HR, 1.85; 95% CI, 1.17‐2.95) further influenced CIHL development over time.
Conclusions
In young children, the cumulative incidence of CIHL is higher compared with that in older children and develops early during therapy. The course of CIHL is further influenced by the total cumulative dose of cisplatin and other ototoxic (co‐)medication. These results highlight the need for audiological monitoring at each cisplatin cycle.
In young children, the cumulative incidence of cisplatin‐induced hearing loss is higher compared with that in older children and develops early during therapy. The course of cisplatin‐induced hearing loss development over time is further influenced by the total cumulative dose of cisplatin, vincristine treatment, and total duration of concomitantly administered antibiotics.
Abstract Introduction Patients with head and neck squamous cell carcinoma (HNSCC) treated with cisplatin‐based chemoradiotherapy (CRT) frequently experience irreversible sensorineural hearing loss ...(SNHL). Patients with low lumbar skeletal muscle index (LSMI) may experience higher serum peak dosages of cisplatin. This study investigated whether pre‐treatment low LSMI is associated with increased SNHL upon cisplatin‐based CRT. Materials and methods LSMI was assessed using routine pre‐treatment CT scans. Pure tone audiometry was performed at baseline and at follow‐up to assess treatment‐related SNHL. Linear mixed models were used to reveal a potential association between the continuous variable LSMI and SNHL. Results This retrospective cohort study included 81 patients and found a significant association between low LSMI and increased treatment‐related SNHL at pure tone frequencies vital for the perception of speech (averaged of 1, 2, and 4 kHz) ( p = 0.048). Conclusions HNSCC patients with low LSMI suffer increased treatment‐related SNHL upon cisplatin‐based CRT.
ABSTRACT Background The role of patients in healthcare research is slowly evolving, although patient roles in the research process are limited. This paper reports on a patient‐led research project ...aiming to develop a musical hearing training programme for patients with a cochlear implant (CI): the Musi‐CI programme. A CI is an inner ear prosthesis that allows people with severe hearing loss to hear. However, while speech can be understood, CI users cannot fully enjoy music or feel aversion to it. The Musi‐CI programme aims to reduce this music aversion to ultimately improve music enjoyment and social participation. The development of the Musi‐CI programme was supported by a consortium of professionals in CI rehabilitation and research. The aim of this paper is to describe and evaluate the Musi‐CI programme development process and its impact on professional CI rehabilitation and research. Methods Programme development was described using a 3‐layered process model of action research, distinguishing the CI user process, the healthcare professional process and the research process. To evaluate perceptions on the programme development process, consortium partners provided written comments and participated in a reflexive evaluation session that was video‐recorded. Reflexive evaluation aims for collective learning and strengthening collaboration among participants. Written comments and video data were analysed using template analysis. Results The involvement of an expert by experience was perceived as challenging but rewarding for all consortium partners, opening up new perspectives on CI‐rehabilitation practice and research. Data analysis revealed two themes on the programme development process, professional space and acknowledgement, and two themes on the outcomes on CI rehabilitation and research: critical reflection and paradigm shift. Conclusion Experts by experience represent a different knowledge domain that may contribute to change in rehabilitation and research. Patient or Public Contribution The development of the programme was initiated by a professional musician and CI user who organized the funding, had a leading role throughout the research process, including the write‐up of the results, and co‐authored this paper.
•Childhood cancer patients and survivors seem at higher risk for tinnitus development compared to siblings.•Platinum agents, high dose cranial radiation and central nervous system tumors are risk ...factors for tinnitus development.•Regular screening for tinnitus and information providing before, during and after childhood cancer therapy is recommended.
Tinnitus can occur during and after treatment for childhood cancer. Studies on the occurrence of, and risk factors for tinnitus during and after childhood cancer treatment are scarce. The aim of this study is to get insight into the frequency and risk factors of tinnitus during and after childhood cancer therapy, based on a review of all previously reported literature.
Systematic electronic literature searches that combined childhood cancer with different treatments and tinnitus terms were performed in the databases EMBASE, Medline, Cochrane, Web of Science, and Google Scholar. Studies were included based on reporting the frequency of tinnitus during and/or after childhood cancer, with 75% of participants being under the age of 25 at time of diagnosis, diagnosed with any type of childhood malignancy and treated with any type of chemotherapy and/or radiotherapy. A risk of bias assessment per research question was performed.
Tinnitus incidence rates were reported up to 15.9 (95% CI 11.8–21.4) during therapy and up to 5.4 (95% CI 4.3–6.9) more than 5 years after diagnosis. The relative risk of developing tinnitus as compared to siblings during and after childhood cancer therapy were reported up to 17.2 (95% CI 11.8–25.0) during therapy and up to 3.7 (95% CI 2.7–5.1) more than 5 years after diagnosis. Independent risk factors for tinnitus development included high dose cranial radiation and platinum based chemotherapy.
The frequency of and risk to develop tinnitus seems to be higher in childhood cancer patients and survivors as compared to the normal population. Regular tinnitus screening before, during and after therapy with standardized questionnaires for early detection seems therefore reasonable in order to identify high-risk patients and eventually develop successful clinical preventive, supportive and management strategies.
Abstract
Background
Tinnitus is a serious late effect of childhood cancer treatment. The aim of this study was to determine the occurrence and risk factors for tinnitus in a national cohort of ...childhood cancer survivors (CCS).
Methods
Data were collected within the national Dutch Childhood Oncology Group - Long-Term Effects after Childhood Cancer (DCOG-LATER) cohort by a self-reported health questionnaire among 5327 Dutch CCS treated between 1963 and 2002. Siblings (N = 1663) were invited to complete the same questionnaire. Relevant patient characteristics and treatment factors were obtained from the Dutch LATER database. The occurrence of tinnitus in survivors was compared to siblings. To study the effect of risk factors, multivariate logistic regression models were estimated.
Results
In total, 2948 CCS and 1055 siblings completed the tinnitus item. Tinnitus was reported in 9.5% of survivors and in 3.7% of siblings (odds ratio OR 3.0, 95% confidence interval CI 2.9–3.1). Risk factors associated with tinnitus in CCS were total cumulative dose cisplatin ≥400 mg/m2 (OR 2.4, 95% CI 1.4–4.0), age at diagnosis (≥10 years: OR 2.1, 95% CI 1.6–2.8), cranial irradiation/total body irradiation (TBI; OR 1.9, 95% CI 1.5–2.5), and neuro/ear, nose, throat (ENT) surgery (OR 1.8, 95% CI 1.1–2.9). Fifty-one percent of CCS with tinnitus had received treatment with either cisplatin, cranial irradiation/TBI, and/or neuro/ENT surgery.
Conclusions
Tinnitus in CCS was present nearly 3 times more often than in siblings. Awareness in CCS previously treated with cisplatin, cranial irradiation/TBI, and/or neuro/ENT surgery is warranted. As only half of affected CCS had a history of these treatments, it seems that other factors might be associated with tinnitus occurrence in this population.
Digital noise reduction systems in modern digital hearing aids aim to improve either speech intelligibility or listening comfort. Little is known, however, about the actual gain reduction produced by ...different noise reduction systems. The aim of this study is to compare the gain reduction of different noise reduction systems.
We applied a systematic variation of different presentation levels of the input signal, different signal-to-noise ratios, and different target hearing loss configurations. The gain reduction of 12 different hearing aids was compared both qualitatively and quantitatively by means of principal value decomposition.
The results show that these hearing aids differ considerably in their responses. These differences are presented qualitatively by plotting contour maps that give the gain reduction as function of signal-to-noise-ratio and frequency. The quantitative analysis shows that the gain reduction produced by most hearing aids can be characterized by two transfer functions. The most important being an overall gain reduction. In addition to this, the frequency response is tilted to achieve either more low-frequency reduction and less high-frequency reduction, or the opposite.
Childhood, adolescent, and young adult (CAYA) cancer survivors treated with platinum-based drugs, head or brain radiotherapy, or both have an increased risk of ototoxicity (hearing loss, tinnitus, or ...both). To ensure optimal care and reduce consequent problems—such as speech and language, social–emotional development, and learning difficulties—for these CAYA cancer survivors, clinical practice guidelines for monitoring ototoxicity are essential. The implementation of surveillance across clinical settings is hindered by differences in definitions of hearing loss, recommendations for surveillance modalities, and remediation. To address these deficiencies, the International Guideline Harmonization Group organised an international multidisciplinary panel, including 32 experts from ten countries, to evaluate the quality of evidence for ototoxicity following platinum-based chemotherapy and head or brain radiotherapy, and formulate and harmonise ototoxicity surveillance recommendations for CAYA cancer survivors.
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