A Retrospective Evaluation of Ototoxicity Monitoring in a Cohort of Pediatric Patients With Solid Tumors, Treated in the Dutch National Cancer Center

Abstract

Introduction: Ototoxicity is an adverse effect of childhood cancer treatment with a negative impact on speech-language development and quality of life. This study aimed to retrospectively assess ototoxicity monitoring in a national cohort of pediatric patients with solid tumors, examining the frequency and determinants associated with hearing loss (HL). Methods: This retrospective cohort study included 305 patients treated between 2015 and 2020 at the Princess Máxima Center. Patients receiving platinum agents, head and neck radiotherapy, and/or ear-nose-throat surgery were analyzed. Electronic patient files provided demographic, clinical, and audiological data. HL was defined as Muenster ≥ 2b or SIOP ≥ 2 grade. Associations between clinical characteristics and HL occurrence were analyzed using logistic regression analysis. Results: Audiological monitoring was performed at baseline (62.6%), during treatment (79.0%), and at the end of treatment (82.1%). Post treatment, 51.2% and 36.5% experienced Muenster and SIOP-defined HL, respectively. Multivariable analyses revealed that age at diagnosis (OR 0.9, 95% CI 0.9–1.0), total cumulative dose cisplatin per 100 mg/m2 (OR 1.6, 95% CI 1.4–2.0), and vincristine treatment (OR 3.3, 95% CI 1.4–7.8) remained significantly associated with Muenster grade ≥ 2b HL. Age at diagnosis in years (OR 0.9, 95% CI 0.8–1.0), total cumulative dose cisplatin per 100 mg/m2 (OR 1.5, 95% CI 1.2–1.8), and male sex (OR 2.7, 95% CI 1.4–5.3) were associated with SIOP ≥ 2 HL. Conclusion: This study shows that more than half of the children treated with ototoxic cancer therapies develop HL by the end of treatment. Therefore, audiological monitoring during and after treatment is essential. Improved insight into clinical determinants aids in identifying patients at high risk for HL, who may benefit from prevention strategies that are currently being implemented.