Hearing changes in pediatric cancer patients treated with cisplatin

José L. Olvera-Gómez, Coordinación de Planeación y Enlace Institucional, Delegación Sur, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México
Yamileth García-Rojas, Servicio de Audiología y Foniatría, Hospital Infantil de México Federico Gómez, Ciudad de México, México
María C. Rojas-Sosa, División de Unidades Médicas de Rehabilitación, Dirección de Prestaciones Médicas, IMSS, Ciudad de México, México
Candy S. Márquez-Ávila, Servicio de Audiología y Foniatría, Hospital Infantil de México Federico Gómez, Ciudad de México, México
María A. Fierro-Evans, Servicio de Audiología y Foniatría, Hospital Infantil de México Federico Gómez, Ciudad de México, México

Objective: To measure changes in hearing assessed by tone audiometry and otoacoustic emissions by product distortions (OAEPD) in children with cancer treated with cisplatin. Method: Retrospective cohort study. There were 42 files of children with cancer, who had tone audiometry (conventional frequencies and high frequencies) and EOAPD, performed after each dose of cisplatin. Hearing was compared with cisplatin amount and doses number. Results: Of the 42 subjects, 88.1% were patients with criteria for ototoxicity (pCCO) and 11.9% without criteria (pSCO). Antineoplastic therapy was administered in 2 (31%) and 3 (69%) doses. In the second study, there was superficial damage in medium and high tones in pCCO (p < 0.046). The high frequencies were affected from first dose in pCCO and second dose in pSCO; the damage was related with accumulated dose (r_s = 0.54; p = 0.0001; odds ratio [OR]: 1.125; 95% confidence interval [95%CI]: 0.893-1.417) in doses of 300-325 mg/m² of body surface. EOAPD were absent in 100% of pCCO at the last dose (OR: 4.0; 95%CI: 0.733-21.838) at 300-325 mg/m2 of body surface (p = 0.034). Conclusions: The use of cisplatin in children with cancer was associated with hearing damage between 2000 and 16,000 Hz from the start of treatment and at dose of 300 mg/m2 of body surface.

Keywords: Cisplatin. Pediatric cancer. Otoacoustic emissions. Hearing loss. Ototoxicity.