Late Onset Hearing Loss: A Significant Complication of Cancer Survivors Treated With Cisplatin Containing Chemotherapy Regimens

Cisplatin is a known ototoxic agent and has been associated with late onset hearing loss (LOHL) in children beyond completion of treatment. We completed a retrospective review of 160 patients yielding 59 who received cisplatin and had sufficient data to determine the presence of LOHL. LOHL was defined as a significant change in hearing thresholds 6 months past the last cisplatin therapy. A significant change was defined as a decrease of > 15 dB in a frequency from 1 to 8 kHz in either ear, or a decrease of 10 dB at 2 or more frequencies in the same ear, compared with the previously entered audiogram. Hearing loss was classified using the Brock grading system for each ear. Of the 59 patients evaluated, 51% exhibited LOHL. Univariate analysis indicated LOHL was significantly associated with age of diagnosis (P = 0.031), diagnosis of medulloblastoma (P = 0.035), hearing aids (P = 0.010), and cranial radiation (P = 0.044), particularly to the posterior fossa (P = 0.023). Multivariate analysis revealed only radiation to the posterior fossa (P = 0.02) and the use of hearing aids (P = 0.01) were significantly associated with LOHL. LOHL is a significant complication in childhood cancer survivors who receive cisplatin. Long-term audiologic monitoring after therapy is needed to identify the affected patients.