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KMID : 0387820170240020121
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Clinical Pediatric Hematology-Oncology
2017 Volume.24 No. 2 p.121 ~ p.129
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Adverse Factors and the Role of Cisplatin and Vinca Alkaloids for Hearing Impairment in Childhood Cancer Patients and Survivors
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Hur Min-Woo
Hahn Seung-Min
Moon In-Seok
Lim Joo-Yeon
Lee Seul-Mi
Lyu Chuhl-Joo
Han Jung-Woo
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Abstract
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Background: Although combined chemotherapy has increased survival rates among children with cancer, such treatments can induce sensorineural hearing loss. Therefore, we aimed to identify risk factors for hearing impairments in patients with childhood cancer.
Methods: Audiograms were obtained from 115 patients with childhood cancer and survivors (age ＜20 years). Pure tone audiometry (PTA) was performed at octave intervals within the range of 250-8000 Hz. We evaluated clinical risk factors associated with hearing impairments. Hearing loss was evaluated based on the maximal decibel (dB) loss in any frequency for each ear (RAmax or LAmax) and weighted mean dB loss for specific frequencies (RAavg or LAavg).
Results: Forty percent of patients (N=46) exhibited hearing loss ＞20 dB based on the weighted mean value in either ear. Severe hearing impairments were observed in 56% of patients with brain tumors. Although cisplatin or vinca alkaloids were significant risk factors for hearing impairment, the use of both cisplatin and vinca alkaloids exhibited the highest odds ratio for hearing impairment (P＜0.001, ＜0.001 for R/LAmax; P=0.099, 0.039 for R/LAavg). Multivariate analysis revealed that the use of both cisplatin and vinca alkaloids was an independent risk factor for hearing impairment based on RAmax, LAmax, and LAavg (P＜0.001, ＜0.001, 0.039, respectively).
Conclusion: Our findings indicate that cisplatin and vinca alkaloids exert an additive effect on the risk of hearing impairment in survivors of childhood cancer. Further prospective studies are thus required to determine the most effective chemotherapeutic regimen for reducing ototoxicity.
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KEYWORD
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Survivors, Hearing loss, Neoplasms, Cisplatin, Vinca alkaloids
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