Hearing loss after platinum treatment is irreversible in noncranial irradiated childhood cancer survivors

Eva Clemens, Andrica C.H. de Vries, Antoinette am Zehnhoff-Dinnesen, Wim J.E. Tissing, Jacqueline J. Loonen, Saskia F.M. Pluijm, Eline van Dulmen-den Broeder, Dorine Bresters, Birgitta Versluys, Leontien C.M. Kremer, Helena J. van der Pal, Sebastian J.C.C.M. Neggers, Martine van Grotel, Marry M van den Heuvel-Eibrink

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Cisplatin and carboplatin are effective antineoplastic agents. They are also considered to be potentially highly ototoxic. To date, no long-term follow-up data from well-documented cohorts with substantial numbers of childhood cancer survivors (CCS) with platinum-related hearing loss are available. Therefore, in this study, we studied the reversibility of ototoxicity from discontinuation of treatment onwards in a national cohort of platinum-treated survivors with hearing loss at the end of cancer treatment. Of the 168 CCS with follow-up audiograms, we longitudinally evaluated the course of hearing function in 61 CCS who showed hearing impairment at discontinuation of treatment according to the Münster criteria (>20 dB at ≥4–8 kHz). Survivors were treated with platinum (median total cumulative dose cisplatin: 480 mg/m2 and median total cumulative dose carboplatin: 2520 mg/m2). Median follow-up time was 5.5 years (range: 1.0–28.8 years). The results showed that none of these survivors revealed improvement of hearing function even till 28.8 years after discontinuation of treatment (grade <2b during long-term follow-up). An increase in hearing loss with two or three Münster degrees was observed in five of 61 survivors after 1.6–19.6 years. Overall, this indicates that ototoxicity after platinum treatment may be irreversible and that longitudinal clinical audiological monitoring and care is required in long-term survivors of childhood cancer on a large scale.

Original languageEnglish
Pages (from-to)120-129
Number of pages10
JournalPediatric Hematology and Oncology
Issue number2
Early online date2017
Publication statusPublished - 17 Feb 2017


  • Childhood cancer survivors
  • cisplatin
  • hearing loss
  • late effects
  • ototoxicity

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