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Li KH, Zhao YY, Cheng HL, Yang JJ, Chien CY. Ototoxicity among cisplatin, carboplatin, and oxaliplatin in zebrafish model. ENVIRONMENTAL TOXICOLOGY 2024; 39:4058-4065. [PMID: 38661261 DOI: 10.1002/tox.24285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/15/2024] [Accepted: 03/31/2024] [Indexed: 04/26/2024]
Abstract
Platinum-based antineoplastic drugs, including cisplatin, carboplatin, and oxaliplatin, are widely used in the treatment of various cancers. Ototoxicity is a common adverse effect of platinum-based drugs. Ototoxicity leads to irreversible hearing impairment. We hypothesize that different platinum-based drugs exhibit varying ototoxic concentrations, time effects, and ototoxic mechanisms. We tested this hypothesis by using a zebrafish model (pvalb3b: TagGFP) to assess the viability of hair cells collected from zebrafish larvae. Cisplatin, carboplatin, and oxaliplatin were administered at dosages of 100, 200, or 400 μM, and the ototoxic effects of these drugs were assessed 1, 2, or 3 h after administration. Fm4-64 and a TUNEL assay were used to label the membranes of living hair cells and to detect cell apoptosis, respectively. We observed that >50% of hair cells were damaged at 1 h after cisplatin (100 μM) exposure, and this ototoxic effect increased at higher dosages and over time. Owing to the smaller ototoxic effects of carboplatin and oxaliplatin, we conducted higher-strength and longer-duration experiments with these drugs. Neither carboplatin nor oxaliplatin was obviously ototoxic, even at 1600 μM and after 6 h. Moreover, only cisplatin damaged the membranes of the hair cells. Cell apoptosis and significantly increased antioxidant gene expression were observed in only the cisplatin group. In conclusion, cisplatin significantly damages sensory hair cells and has notable dosage and time effects. Carboplatin and oxaliplatin are less ototoxic than cisplatin, likely due to having different ototoxic mechanisms than cisplatin.
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Affiliation(s)
- Kuan-Hui Li
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Otorhinolaryngology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Yu Zhao
- Department of Biomedical Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Hsin-Lin Cheng
- Department of Biomedical Sciences, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jiann-Jou Yang
- Department of Biomedical Sciences, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chen-Yu Chien
- Department of Otorhinolaryngology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Otorhinolaryngology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Otorhinolaryngology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
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Scobioala S, Parfitt R, Matulat P, Byrne J, Langer T, Troschel FM, Hesping AE, Clemens E, Kaatsch P, Grabow D, Kaiser M, Spix C, Kremer LC, Calaminus G, Baust K, Kuehni CE, Weiss A, Strebel S, Kuonen R, Elsner S, Haupt R, Garré ML, Gruhn B, Kepak T, Kepakova K, Winther JF, Kenborg L, Rechnitzer C, Hasle H, Kruseova J, Luks A, Lackner H, Bielack S, Beck JD, Jürgens H, van den Heuvel-Eibrink MM, Zolk O, Eich HT, Am Zehnhoff-Dinnesen A. The impact of the temporal sequence of cranial radiotherapy and platin-based chemotherapy on hearing impairment in pediatric and adolescent CNS and head-and-neck cancer patients: A report from the PanCareLIFE consortium. Int J Cancer 2024; 154:320-331. [PMID: 37715472 DOI: 10.1002/ijc.34732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/11/2023] [Accepted: 08/23/2023] [Indexed: 09/17/2023]
Abstract
The impact of the temporal sequence by which cranial radiotherapy (CRT) and platin-based chemotherapy (PCth) are administered on sensorineural hearing loss (SNHL) in pediatric and adolescent central nervous system (CNS) and head-and-neck (HN) cancer patients has not yet been studied in detail. We examined the ototoxic effects of sequentially applied CRT and PCth. This study included children and adolescents with CNS and HN tumors who participated in the multicountry PanCareLIFE (PCL) consortium. Audiological outcomes were compared between patients who received CRT prior to PCth and those who received it afterwards. The incidence, degree and posttreatment progression of SNHL, defined as Muenster classification grade ≥MS2b, were evaluated in 141 patients. One hundred and nineteen patients were included in a time-to-onset analysis. Eighty-eight patients received CRT prior to PCth (Group 1) and 53 patients received PCth before CRT (Group 2). Over a median follow-up time of 1.6 years, 72.7% of patients in Group 1 experienced SNHL ≥ MS2b compared to 33.9% in Group 2 (P < .01). A time-to-onset analysis was performed for 74 patients from Group 1 and 45 patients from Group 2. Median time to hearing loss (HL) ≥ MS2b was 1.2 years in Group 1 and 4.4 years in Group 2 (P < .01). Thus, audiological outcomes were better for patients who received CRT after PCth than before. This finding should be further evaluated and considered within clinical practice in order to minimize hearing loss in children and adolescents with CNS and HN tumors.
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Affiliation(s)
- Sergiu Scobioala
- Clinic for Radiotherapy, Radiooncology University Hospital Muenster, Muenster, Germany
| | - Ross Parfitt
- Department for Phoniatrics and Pedaudiology, University Hospital, Muenster, UKM, Germany
| | - Peter Matulat
- Department for Phoniatrics and Pedaudiology, University Hospital, Muenster, UKM, Germany
| | | | - Thorsten Langer
- Pediatric Oncology and Hematology, University Hospital for Children and Adolescents, University of Luebeck, Luebeck, Germany
| | - Fabian M Troschel
- Clinic for Radiotherapy, Radiooncology University Hospital Muenster, Muenster, Germany
| | - Amélie E Hesping
- Department for Phoniatrics and Pedaudiology, University Hospital, Muenster, UKM, Germany
| | - Eva Clemens
- Erasmus University Medical Centre (EMC), Rotterdam, The Netherlands
| | - Peter Kaatsch
- German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Desiree Grabow
- Division of Childhood Cancer Epidemiology, German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Melanie Kaiser
- Division of Childhood Cancer Epidemiology, German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Claudia Spix
- Division of Childhood Cancer Epidemiology, German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Leontien C Kremer
- Academisch Medisch Centrum bij de Universiteit van Amsterdam (AMC), Amsterdam, The Netherlands
- Princess Maxima Center for Pediatric Oncology (PMC), and University of Utrecht, Utrecht, The Netherlands
| | - Gabriele Calaminus
- Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - Katja Baust
- Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Annette Weiss
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sven Strebel
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Rahel Kuonen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Susanne Elsner
- Pediatric Oncology and Hematology, University Hospital for Children and Adolescents, University of Luebeck, Luebeck, Germany
| | - Riccardo Haupt
- DOPO Clinic and Neuroncology Unit, Department of Hematology/Oncology, IRCCS Istituto Giannina Gaslini (IGG), Genoa, Italy
| | - Maria-Luisa Garré
- DOPO Clinic and Neuroncology Unit, Department of Hematology/Oncology, IRCCS Istituto Giannina Gaslini (IGG), Genoa, Italy
| | - Bernd Gruhn
- Department of Pediatrics, Jena University Hospital, Jena, Germany
| | - Tomas Kepak
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
- Department of Paediatric Oncology, University Hospital Brno, Brno, Czech Republic
| | - Katerina Kepakova
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
- Department of Paediatric Oncology, University Hospital Brno, Brno, Czech Republic
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Line Kenborg
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Catherine Rechnitzer
- Pediatric and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Henrik Hasle
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | | | - Ales Luks
- Motol Teaching Hospital, Prague, Czech Republic
| | - Herwig Lackner
- Pediatric Hematology and Oncology, Medical University of Graz, Graz, Austria
| | - Stefan Bielack
- Pediatrics 5 (Oncology, Hematology, Immunology), Center for Pediatric, Adolescent, and Women's Medicine, Stuttgart Cancer Center, Klinikum Stuttgart-Olgahospital, Stuttgart, Germany
| | - Jörn-Dirk Beck
- Pediatric Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Heribert Jürgens
- Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany
| | | | - Oliver Zolk
- Institute of Clinical Pharmacology, Brandenburg Medical School, Rüdersdorf, Germany
| | - Hans Theodor Eich
- Clinic for Radiotherapy, Radiooncology University Hospital Muenster, Muenster, Germany
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Funt SA, Knezevic A, Wilson K, Bromberg M, Budnick A, O’Connor KL, McHugh DJ, Larsen E, Bajorin DF, Motzer RJ, Tonorezos ES, Patil S, Feldman DR. Ototoxicity associated with high-dose carboplatin for patients with previously treated germ cell tumors. Cancer 2023; 129:3952-3961. [PMID: 37715631 PMCID: PMC11305123 DOI: 10.1002/cncr.34991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/26/2023] [Accepted: 07/18/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND High-dose carboplatin is an essential part of curative high-dose chemotherapy (HDCT) for patients with previously treated germ cell tumors (GCTs). Although hearing loss (HL) is a known side effect of HDCT, data on its severity and characteristics are limited. METHODS Eligible patients received HDCT for GCTs from 1993 to 2017 and had audiograms before and after HDCT. HL severity was classified by American Speech-Language-Hearing Association criteria, and mean change in hearing threshold at each frequency (0.25-8 kHz) was estimated from pre- to post-HDCT and between HDCT cycles. RESULTS Of 115 patients (median age, 32 years), 102 (89%) received three cycles of HDCT. Of 106 patients with normal hearing to mild HL in the speech frequencies (0.5-4 kHz) before HDCT, 70 (66%) developed moderate to profound HL in the speech frequencies after HDCT. Twenty-five patients (22%) were recommended for hearing aids after HDCT. Patients with moderate to profound HL isolated to the higher frequencies (6-8 kHz) before HDCT were more likely to develop moderate to profound HL in the speech frequencies after HDCT (94% vs. 61%; p = .01) and to be recommended for hearing aids (39% vs. 18%; p = .05). CONCLUSIONS HL was frequent after HDCT for GCTs, with most patients developing at least moderate HL in the speech frequencies and approximately one in five recommended for hearing aids. Moderate to profound HL isolated to high frequencies at baseline was predictive of more clinically significant hearing impairment after HDCT. PLAIN LANGUAGE SUMMARY Some patients with germ cell tumors, the most common malignancy in adolescent and young adult men, are not cured with standard-dose chemotherapy and require high-dose chemotherapy (HDCT). Using detailed hearing assessments of patients receiving HDCT, we found that most patients developed significant hearing loss and that one in five needed hearing aids. Thus, strategies to reduce this side effect are urgently needed, and all patients receiving HDCT should have a hearing test after therapy.
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Affiliation(s)
- Samuel A. Funt
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - Andrea Knezevic
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Kaamilah Wilson
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Maria Bromberg
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Amy Budnick
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Kerri L. O’Connor
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Deaglan J. McHugh
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - Erik Larsen
- Formerly of Decibel Therapeutics, Boston, MA, USA
| | - Dean F. Bajorin
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - Robert J. Motzer
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | | | - Sujata Patil
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- Department of Biostatistics, Cleveland Clinic, Cleveland, Ohio, USA
| | - Darren R. Feldman
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
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Freyer DR, Orgel E, Knight K, Krailo M. Special considerations in the design and implementation of pediatric otoprotection trials. J Cancer Surviv 2023; 17:4-16. [PMID: 36637630 DOI: 10.1007/s11764-022-01312-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/07/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE Cisplatin-induced hearing loss (CIHL) is a common late effect after childhood cancer treatment having profound, lifelong consequences that lower quality of life. The recent identification of intravenous sodium thiosulfate (STS) as an effective agent for preventing pediatric CIHL represents a paradigm shift that has created new opportunities for expanding STS usage and developing additional otoprotectants. The purpose of this paper is to discuss key considerations and recommendations for the design and implementation of future pediatric otoprotection trials. METHODS An approach synthesizing published data and collective experience was used. RESULTS Key issues were identified in the categories of translational research, trial designs for systemic and intratympanic agents, measurement of ototoxicity, and biostatistical challenges. CONCLUSIONS Future pediatric otoprotection trials should emphasize (1) deep integration of preclinical and early-phase studies; (2) an embedded or free-standing design for systemic agents based on mechanistic considerations; (3) use of suitable audiologic testing batteries for children, SIOP grading criteria, and submission of raw audiologic data for central review; and (4) novel endpoints and innovative study designs that maximize trial efficiency for limited sample sizes. Additional recommendations include routine collection of DNA specimens for assessing modifying effects of genetic susceptibility and meaningful inclusion of patient/family advocates for informing trial development. IMPLICATIONS FOR CANCER SURVIVORS Changing the historical paradigm from acceptance to prevention of pediatric CIHL through expanded research with existing and emerging otoprotectants will dramatically improve quality of life for future childhood cancer survivors exposed to cisplatin.
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Affiliation(s)
- David R Freyer
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA.
- Departments of Pediatrics, Medicine, and Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Etan Orgel
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kristin Knight
- Department of Audiology, Doernbecher Children's Hospital, Portland, OR, USA
- Oregon Health and Science University, Portland, OR, USA
| | - Mark Krailo
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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Generotti C, Cox BC, Singh J, Hamilton D, McKenzie E, O'Malley BW, Li D. Subclinical diagnosis of cisplatin-induced ototoxicity with biomarkers. Sci Rep 2022; 12:18032. [PMID: 36302835 PMCID: PMC9613680 DOI: 10.1038/s41598-022-23034-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/25/2022] [Indexed: 01/24/2023] Open
Abstract
A mouse model with cisplatin-induced ototoxicity was used in addition to human samples from the ITMAT Biobank at the University of Pennsylvania. Mouse auditory brainstem responses (ABR), inner ear histology, perilymph cisplatin sampling, and measurement of serum prestin via ELISA were performed. Human serum prestin level was measured via ELISA in patients with otological issues after cisplatin treatment and compared to matched controls. Serum prestin was significantly elevated before ABR threshold shifts in mice exposed to cisplatin compared to control mice. Prestin concentration also correlated with the severity of hearing threshold shifts in mice. After an extended rest post-cisplatin treatment, prestin returned to baseline levels in mice and humans. Prestin was significantly elevated in the serum before the onset of objective hearing loss and correlated with the severity of hearing damage indicating that prestin may function as an effective biomarker of cisplatin-induced ototoxicity. Human serum prestin levels responded similarly to mice > 3 weeks from ototoxic exposure with decreased levels of prestin in the serum.
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Affiliation(s)
- Charles Generotti
- Department of Otolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 421 Curie Blvd., BRB 1212, Philadelphia, PA, 19104, USA
| | - Brandon C Cox
- Department of Pharmacology, Southern Illinois University School of Medicine, 801 N. Rutledge St, Springfield, IL, 62702, USA
| | - Jarnail Singh
- Department of Pharmacology, Southern Illinois University School of Medicine, 801 N. Rutledge St, Springfield, IL, 62702, USA
| | - Deborah Hamilton
- Department of Pharmacology, Southern Illinois University School of Medicine, 801 N. Rutledge St, Springfield, IL, 62702, USA
| | - Erica McKenzie
- Department of Civil and Environmental Engineering, Temple University, Philadelphia, PA, 19122, USA
| | - Bert W O'Malley
- University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA
| | - Daqing Li
- Department of Otolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 421 Curie Blvd., BRB 1212, Philadelphia, PA, 19104, USA.
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DuBois SG, Macy ME, Henderson TO. High-Risk and Relapsed Neuroblastoma: Toward More Cures and Better Outcomes. Am Soc Clin Oncol Educ Book 2022; 42:1-13. [PMID: 35522915 DOI: 10.1200/edbk_349783] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Approximately half of the patients diagnosed with neuroblastoma are classified as having high-risk disease. This group continues to have inadequate cure rates despite multiagent chemotherapy, surgery, high-dose chemotherapy with autologous stem cell rescue, and immunotherapy directed against GD2. We review current efforts to try to improve outcomes in patients with newly diagnosed disease by integrating novel targeted therapies earlier in the course of the disease. We further examine a growing list of options available for patients with relapsed or refractory high-risk disease, with an eye toward graduating successful strategies from a relapsed/refractory setting to the frontline setting. Last, we review efforts to study and potentially mitigate the array of late effects faced by survivors of high-risk neuroblastoma.
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Affiliation(s)
- Steven G DuBois
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | - Margaret E Macy
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Tara O Henderson
- Department of Pediatrics, University of Chicago Pritzker School of Medicine, Chicago, IL
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Sánchez-Canteli M, Núñez-Batalla F, Martínez-González P, de Lucio-Delgado A, Antonio Villegas-Rubio J, Gómez-Martínez JR, Luis Llorente-Pendás J. Ototoxicity in cancer survivors: Experience and proposal of a surveillance protocol. An Pediatr (Barc) 2021; 95:290-297. [PMID: 34702687 DOI: 10.1016/j.anpede.2020.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/26/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Ototoxicity occurs in different percentages in patients after treatment with platinum-based chemotherapy or cranial radiation therapy. The aim of this study was to present our experience in ototoxicity monitoring. MATERIAL AND METHODS A review was made of the registry of paediatric cancer patients referred to the Children's Hearing Loss Unit from 1999 to 2019. RESULTS Of the 46 patients referred to this unit, 41 had received platinum as part of their treatment, 17 patients underwent neurosurgery, and 18 patients received cranial radiation therapy. An anamnesis and otoscopy were performed on all of them, and the monitoring was carried out with tone-verbal audiometry and/or distortion products. Hearing loss was observed in eight patients (21.05% of patients referred for audiological follow-up) as a consequence of the treatment. It was impossible to determine the audiological situation in eight patients at the end of treatment. Hearing aid adaption was necessary in two patients. In coordination with Paediatric Oncology, a change from cisplatin to carboplatin due to bilateral grade two ototoxicity was considered appropriate during treatment in one patient. CONCLUSION Adequate coordination with Paediatric Oncology is essential to carry out active surveillance for ototoxicity and to modify, if possible, the dosage or type of chemotherapy in case hearing is affected. In our experience, and following current recommendations, a pre-treatment assessment is usually performed, as well as monitoring during treatment, at the end of treatment, and annually thereafter due to the risk of a later development of hearing loss.
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Affiliation(s)
- Mario Sánchez-Canteli
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.
| | - Faustino Núñez-Batalla
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain
| | - Patricia Martínez-González
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ana de Lucio-Delgado
- Oncología Pediátrica, Servicio de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Justo Ramón Gómez-Martínez
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain
| | - José Luis Llorente-Pendás
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain
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Long-term follow-up of high-risk neuroblastoma survivors treated with high-dose chemotherapy and stem cell transplantation rescue. Bone Marrow Transplant 2021; 56:1984-1997. [PMID: 33824435 DOI: 10.1038/s41409-021-01258-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 02/08/2021] [Accepted: 02/23/2021] [Indexed: 11/08/2022]
Abstract
Intensive treatments including high-dose chemotherapy (HDC) with autologous stem cell rescue have improved high-risk neuroblastoma (HRNB) survival. We report the long-term health status of 145 HRNB survivors, alive and disease-free 5 years post HDC. Median follow-up was 15 years (range = 5-34). Six patients experienced late relapses, 11 developed second malignant neoplasms (SMNs), and 9 died. Event-free and overall survivals 20 years post HDC were 82% (95% CI = 70%-90%) and 89% (78%-95%), respectively. Compared with the French general population, the standardized mortality ratio was 19 (95% CI = 8.7-36.1; p < 0.0001) and the absolute excess risk was 37.6 (19.2-73.5). Late effects were observed in 135/145 patients (median = 3 events/patient); 103 had at least one severe event. SMNs arose at a median of 20 years post HDC and included carcinoma (n = 5), sarcoma (2), acute myeloid leukemia (2), melanoma (1), and malignant glioma (1). Non-oncologic health events included dental maldevelopment (60%), severe hearing loss (20% cumulative probability at 15 years), hepatic focal nodular hyperplasia (14%), thyroid (11%), cardiac (8%), and renal (7%) diseases and growth retardation (height-for-age z-score ≤ -2 for 21%). Gonadal insufficiency was near-universal after busulfan (40/43 females, 33/35 males). Severe late effects are frequent and progressive in HRNB survivors needing systematic very long-term follow-up.
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Sánchez-Canteli M, Núñez-Batalla F, Martínez-González P, de Lucio-Delgado A, Villegas-Rubio JA, Gómez-Martínez JR, Llorente-Pendás JL. [Ototoxicity in cancer survivors: experience and proposal of a surveillance protocol]. An Pediatr (Barc) 2020; 95:S1695-4033(20)30296-4. [PMID: 32998843 DOI: 10.1016/j.anpedi.2020.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Ototoxicity occurs in different percentages in patients after treatment with platinum-based chemotherapy or cranial radiation therapy. The aim of this study was to present experience in ototoxicity monitoring. MATERIAL AND METHODS A review was made of the registry of paediatric cancer patients referred to the Children's Hearing Loss Unit from 1999 to 2019. RESULTS Of the 46 patients referred to this unit, 41 had received platinum as part of their treatment, 17 patients underwent neurosurgery, and 18 patients received cranial radiation therapy. An anamnesis and otoscopy were performed on all of them, and the monitoring was carried out with tone-verbal audiometry and/or distortion products. Hearing loss was observed in eight patients (21.05% of patients referred for audiological follow-up) as a consequence of the treatment. It was impossible to determine the audiological situation in eight patients at the end of treatment. Hearing aid adaption was necessary in two patients. In coordination with Paediatric Oncology, a change from cisplatin to carboplatin due to bilateral grade two ototoxicity was considered appropriate during treatment in one patient. CONCLUSION Adequate coordination with Paediatric Oncology is essential to carry out active surveillance for ototoxicity and to modify, if possible, the dosage or type of chemotherapy in case hearing is affected. In our experience, and following current recommendations, a pre-treatment assessment is usually performed, as well as monitoring during treatment, at the end of treatment, and annually thereafter due to the risk of a later development of hearing loss.
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Affiliation(s)
- Mario Sánchez-Canteli
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España.
| | - Faustino Núñez-Batalla
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España; Universidad de Oviedo, Oviedo, España
| | - Patricia Martínez-González
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España
| | - Ana de Lucio-Delgado
- Oncología Pediátrica, Servicio de Pediatría, Hospital Universitario Central de Asturias, Oviedo, España
| | | | - Justo Ramón Gómez-Martínez
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España; Universidad de Oviedo, Oviedo, España
| | - José Luis Llorente-Pendás
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España; Universidad de Oviedo, Oviedo, España
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10
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Gersten BK, Fitzgerald TS, Fernandez KA, Cunningham LL. Ototoxicity and Platinum Uptake Following Cyclic Administration of Platinum-Based Chemotherapeutic Agents. J Assoc Res Otolaryngol 2020; 21:303-321. [PMID: 32583132 PMCID: PMC7445222 DOI: 10.1007/s10162-020-00759-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/22/2020] [Indexed: 01/04/2023] Open
Abstract
Cisplatin is a widely used anti-cancer drug used to treat a variety of cancer types. One of the side effects of this life-saving drug is irreversible ototoxicity, resulting in permanent hearing loss in many patients. In order to understand why cisplatin is particularly toxic to the inner ear, we compared the hearing loss and cochlear uptake of cisplatin to that of two related drugs, carboplatin and oxaliplatin. These three drugs are similar in that each contains a core platinum atom; however, carboplatin and oxaliplatin are considered less ototoxic than cisplatin. We delivered these three drugs to mice using a 6-week cyclic drug administration protocol. We performed the experiment twice, once using equimolar concentrations of the drugs and once using concentrations of the drugs more proportional to those used in the clinic. For both concentrations, we detected a significant hearing loss caused by cisplatin and no hearing loss caused by carboplatin or oxaliplatin. Cochlear uptake of each drug was measured using inductively coupled plasma mass spectrometry (ICP-MS) to detect platinum. Cochlear platinum levels were highest in mice treated with cisplatin followed by oxaliplatin, while carboplatin was largely excluded from the cochlea. Even when the drug doses were increased, cochlear platinum remained low in mice treated with oxaliplatin or carboplatin. We also examined drug clearance from the inner ear by measuring platinum levels at 1 h and 24 h after drug administration. Our findings suggest that the reduced cochlear platinum we observed with oxaliplatin and carboplatin were not due to increased clearance of these drugs relative to cisplatin. Taken together, our data indicate that the differential ototoxicity among cisplatin, carboplatin, and oxaliplatin is attributable to differences in cochlear uptake of these three drugs.
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Affiliation(s)
- Benjamin K Gersten
- Section on Sensory Cell Biology, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, 20814, USA
| | - Tracy S Fitzgerald
- Mouse Auditory Testing Core, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, 20814, USA
| | - Katharine A Fernandez
- Section on Sensory Cell Biology, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, 20814, USA. .,Porter Neuroscience Research Center, 35A Convent Drive, Room 1D-955, Bethesda, MD, 20892, USA.
| | - Lisa L Cunningham
- Section on Sensory Cell Biology, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, 20814, USA
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11
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Gertson K, Hayashi SS, Trinkaus K, Wan F, Hayashi RJ. Prevalence of Ototoxicity Following Hematopoietic Stem Cell Transplantation in Pediatric Patients. Biol Blood Marrow Transplant 2019; 26:107-113. [PMID: 31494228 DOI: 10.1016/j.bbmt.2019.08.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/29/2019] [Accepted: 08/29/2019] [Indexed: 02/07/2023]
Abstract
The use of hematopoietic stem cell transplantation (HSCT) is increasing for a variety of diseases. Ototoxicity from this procedure has not been extensively studied. A retrospective chart review examined 275 patients from this institution who underwent HSCT between January 1, 2007, and April 30, 2017. Data extracted included therapy before HSCT and the subsequent course of transplantation. Evaluable patients had complete medical records and interpretable audiograms available. Ototoxicity constituted significant threshold changes from baseline or changes in International Society of Pediatric Oncology/Boston Ototoxicity Grading Scale (SIOP) grade comparing audiogram results just before HSCT with those following the transplantation procedure. A total of 147 patients were evaluable. Ototoxicity was observed in 10.2% of the patients. Higher SIOP grade before HSCT was significantly associated with a higher risk of post-transplantation ototoxicity (P < .01). Previous cisplatin treatment (P < .0001), but not carboplatin or radiation treatment, was also associated with ototoxicity. Patients with a solid tumor or brain tumor (P < .0001) and those who received an autologous transplant (P = .0002) were also at increased risk. No post-transplantation event was significantly associated with ototoxicity. Ototoxicity affects a significant percentage of patients undergoing HSCT, and careful monitoring is needed to identify patients impacted by this procedure.
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Affiliation(s)
- Kristen Gertson
- Program in Audiology and Communication Sciences, Washington University School of Medicine, St Louis, Missouri
| | - Susan S Hayashi
- Audiology Division, St Louis Children's Hospital, St Louis, Missouri
| | - Kathryn Trinkaus
- Biostatistics Shared Resource, Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri
| | - Fei Wan
- Biostatistics Shared Resource, Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri
| | - Robert J Hayashi
- Siteman Cancer Center, Washington University School of Medicine, St. Louis Children's Hospital, St Louis, Missouri.
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12
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Clemens E, Brooks B, de Vries ACH, van Grotel M, van den Heuvel-Eibrink MM, Carleton B. A comparison of the Muenster, SIOP Boston, Brock, Chang and CTCAEv4.03 ototoxicity grading scales applied to 3,799 audiograms of childhood cancer patients treated with platinum-based chemotherapy. PLoS One 2019; 14:e0210646. [PMID: 30763334 PMCID: PMC6375552 DOI: 10.1371/journal.pone.0210646] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 12/29/2018] [Indexed: 01/12/2023] Open
Abstract
Childhood cancer patients treated with platinums often develop hearing loss and the degree is classified according to different scales globally. Our objective was to compare concordance between five well-known ototoxicity scales used for childhood cancer patients. Audiometric test results (n = 654) were evaluated longitudinally and graded according Brock, Chang, International Society of Pediatric Oncology (SIOP) Boston, Muenster scales and the U.S. National Cancer Institute Common Technology Criteria for Adverse Events (CTCAE) version 4.03. Adverse effects of grade 2, 3 and 4 are considered to reflect a degree of hearing loss sufficient to interfere with day-to-day communication (> = Chang grade 2a; > = Muenster grade 2b). We term this "deleterious hearing loss". A total number of 3,799 audiograms were evaluated. The prevalence of deleterious hearing loss according to the last available audiogram of each patient was 59.3% (388/654) according to Muenster, 48.2% (315/653) according to SIOP, 40.5% (265/652) according to Brock, 40.3% (263/652) according to Chang, and 57.5% (300/522) according to CTCAEv4.03. Overall concordance between the scales ranged from ĸ = 0.636 (Muenster vs. Chang) to ĸ = 0.975 (Brock vs. Chang). Muenster detected hearing loss the earliest in time, followed by Chang, SIOP and Brock. Generally good concordance between the scales was observed but there is still diversity in definitions of functional outcomes, such as differences in distribution levels of severity of hearing loss, and additional intermediate scales taking into account losses <40 dB as well. Regardless of the scale used, hearing function decreases over time and therefore, close monitoring of hearing function at baseline and with each cycle of platinum therapy should be conducted.
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Affiliation(s)
- E. Clemens
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pediatric Hematology and Oncology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - B. Brooks
- Audiology and Speech Pathology Department, British Columbia Children’s Hospital, Vancouver, British Columbia, Canada
| | - A. C. H. de Vries
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pediatric Hematology and Oncology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - M. van Grotel
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - M. M. van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pediatric Hematology and Oncology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - B. Carleton
- BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
- Division of Translational Therapeutics, Department of Pediatrics, The University of British Columbia, Vancouver, British Columbia, Canada
- Pharmaceutical Outcomes Programme, BC Children’s Hospital, Vancouver, British Columbia, Canada
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13
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Clemens E, van den Heuvel-Eibrink MM, Mulder RL, Kremer LCM, Hudson MM, Skinner R, Constine LS, Bass JK, Kuehni CE, Langer T, van Dalen EC, Bardi E, Bonne NX, Brock PR, Brooks B, Carleton B, Caron E, Chang KW, Johnston K, Knight K, Nathan PC, Orgel E, Prasad PK, Rottenberg J, Scheinemann K, de Vries ACH, Walwyn T, Weiss A, Am Zehnhoff-Dinnesen A, Cohn RJ, Landier W. Recommendations for ototoxicity surveillance for childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCare Consortium. Lancet Oncol 2019; 20:e29-e41. [PMID: 30614474 PMCID: PMC7549756 DOI: 10.1016/s1470-2045(18)30858-1] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 01/26/2023]
Abstract
Childhood, adolescent, and young adult (CAYA) cancer survivors treated with platinum-based drugs, head or brain radiotherapy, or both have an increased risk of ototoxicity (hearing loss, tinnitus, or both). To ensure optimal care and reduce consequent problems-such as speech and language, social-emotional development, and learning difficulties-for these CAYA cancer survivors, clinical practice guidelines for monitoring ototoxicity are essential. The implementation of surveillance across clinical settings is hindered by differences in definitions of hearing loss, recommendations for surveillance modalities, and remediation. To address these deficiencies, the International Guideline Harmonization Group organised an international multidisciplinary panel, including 32 experts from ten countries, to evaluate the quality of evidence for ototoxicity following platinum-based chemotherapy and head or brain radiotherapy, and formulate and harmonise ototoxicity surveillance recommendations for CAYA cancer survivors.
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Affiliation(s)
- Eva Clemens
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Hematology and Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands
| | | | - Renée L Mulder
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Melissa M Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Roderick Skinner
- Department of Pediatric and Adolescent Hematology/Oncology and Children's Hematopoietic Stem Cell Transplant Unit, Great North Children's Hospital and Institute of Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Louis S Constine
- Departments of Radiation Oncology and Pediatrics, University of Rochester Medical Center, Rochester, New York, NY, USA
| | - Johnnie K Bass
- Rehabilitation Services, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Claudia E Kuehni
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Pediatrics, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Thorsten Langer
- Pediatric Oncology and Hematology, University Hospital for Children and Adolescents, Lübeck, Germany
| | - Elvira C van Dalen
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Edith Bardi
- Department of Pediatrics and Adolescent Medicine, Kepler Universitätsklinikum, Linz, Austria
| | | | - Penelope R Brock
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Beth Brooks
- Rehabilitation Services, St Jude Children's Research Hospital, Memphis, TN, USA; Audiology and Speech Pathology Department, British Columbia's Children's Hospital, Vancouver, BC, Canada; School of Audiology and Speech Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Bruce Carleton
- Pharmaceutical Outcomes Programme, British Columbia's Children's Hospital, Vancouver, BC, Canada; Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eric Caron
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Kay W Chang
- Department of Otolaryngology, Stanford University, Palo Alto, CA, USA
| | - Karen Johnston
- Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, NSW, Australia
| | - Kristin Knight
- Department of Pediatric Audiology, Child Development and Rehabilitation Center, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, OR, USA
| | - Paul C Nathan
- Department of Pediatrics, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Etan Orgel
- Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Pinki K Prasad
- Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA, USA; Division of Pediatric Hematology/Oncology, Children's Hospital of New Orleans, New Orleans, LA, USA
| | - Jan Rottenberg
- Department of Otolaryngology and Head and Neck Surgery, St Ann's University Hospital Brno, Masaryk University, Brno, Czech Republic
| | - Katrin Scheinemann
- Division of Pediatric Hematology/Oncology, Hospital for Children and Adolescents, Cantonal Hospital Aarau, Aarau, Switzerland; Division of Pediatric Hematology/Oncology, University for Children's Hospital Basel, Basel, Switzerland; Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, McMaster University, Hamilton, ON, Canada
| | - Andrica C H de Vries
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Hematology and Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Thomas Walwyn
- Department of Pediatric and Adolescent Oncology, Perth Children's Hospital, Nedlands, WA, Australia; School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Annette Weiss
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Antoinette Am Zehnhoff-Dinnesen
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, Westphalian Wilhelm University of Münster, Münster, Germany
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, NSW, Australia; School of Women's and Children's Health, University of New South Wales Medicine, Sydney, NSW, Australia
| | - Wendy Landier
- Institute for Cancer Outcomes and Survivorship, Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, AL, USA.
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14
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Late Effects and Survivorship Issues in Patients with Neuroblastoma. CHILDREN-BASEL 2018; 5:children5080107. [PMID: 30082653 PMCID: PMC6111874 DOI: 10.3390/children5080107] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/27/2018] [Accepted: 08/01/2018] [Indexed: 12/19/2022]
Abstract
Over the past two decades, marked progress has been made in understanding the biology of neuroblastoma; this has led to refined risk stratification and treatment modifications with resultant increasing 5-year survival rates for children with neuroblastoma. Survivors, however, remain at risk for a wide variety of potential treatment-related complications, or "late effects", which may lead to excess morbidity and premature mortality in this cohort. This review summarizes the existing survivorship literature on long-term health outcomes for survivors of neuroblastoma, focusing specifically on potential injury to the endocrine, sensory, cardiovascular, pulmonary, and renal systems, as well as survivors' treatment-related risk for subsequent neoplasms and impaired quality of life. Additional work is needed to assess the potential late effects of newer multimodality therapies with the aim of optimizing long-term medical and psychosocial outcomes for all survivors of neuroblastoma.
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15
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Waissbluth S, Del Valle Á, Chuang A, Becker A. Incidence and associated risk factors for platinum-induced ototoxicity in pediatric patients. Int J Pediatr Otorhinolaryngol 2018; 111:174-179. [PMID: 29958605 DOI: 10.1016/j.ijporl.2018.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/28/2018] [Accepted: 06/09/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Platinum-based chemotherapy is effective against a variety of pediatric malignancies. Unfortunately, the use of cisplatin and carboplatin can lead to permanent and progressive sensorineural hearing loss which can affect the quality of life of cancer survivors. The objectives of this study were to evaluate the incidence of platinum-induced ototoxicity in children and analyze potential risk factors. METHODS Prospective cohort study. All pediatric patients receiving chemotherapy with cisplatin and/or carboplatin from 01/2012 until 10/2017 were included. Hearing evaluations were performed before every chemotherapy cycle, and following the end of chemotherapy, with auditory brainstem response, otoacoustic emissions and/or audiometry. Demographics, cumulative doses, cranial irradiation and exposure to other ototoxic agents were analyzed. RESULTS Twenty-eight patients were included, with a mean age of 7.2 years at the beginning of chemotherapy (range 5 months-15 years 2 months); twenty-one patients received cisplatin, four received carboplatin, and three received both agents. Twelve patients had cranial irradiation and seven received another ototoxic medication. The most frequent malignancies were germ cell tumors, medulloblastoma and gliomas. Sensorineural hearing loss occurred in 28.6% of the patients with a mean follow-up period of 21.5 months (range: 1-53 months). All patients evaluated with audiometry had ≥ Chang 2b ototoxicity. Risk factors include age less than 5 years, cranial irradiation, and cisplatin cumulative dose greater than 400 mg/m2. CONCLUSION Sensorineural hearing loss is a potential side effect of platinum-based chemotherapy. Pediatric patients receiving cisplatin chemotherapy with a cumulative dose exceeding 400 mg/m2, cranial irradiation as well as patients younger than 5 years are at greater risk of developing hearing loss.
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Affiliation(s)
- Sofia Waissbluth
- Department of Otolaryngology, Complejo Asistencial Dr. Sotero Del Rio, Santiago, Chile.
| | - Álvaro Del Valle
- Department of Otolaryngology, Complejo Asistencial Dr. Sotero Del Rio, Santiago, Chile
| | - Angela Chuang
- Department of Otolaryngology, Complejo Asistencial Dr. Sotero Del Rio, Santiago, Chile
| | - Ana Becker
- Department of Pediatric Hematology-Oncology, Complejo Asistencial Dr. Sotero Del Rio, Santiago, Chile
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16
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Minasian LM, Frazier AL, Sung L, O’Mara A, Kelaghan J, Chang KW, Krailo M, Pollock BH, Reaman G, Freyer DR. Prevention of cisplatin-induced hearing loss in children: Informing the design of future clinical trials. Cancer Med 2018; 7:2951-2959. [PMID: 29846043 PMCID: PMC6051159 DOI: 10.1002/cam4.1563] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 04/27/2018] [Accepted: 04/29/2018] [Indexed: 11/23/2022] Open
Abstract
Cisplatin is an essential chemotherapeutic agent in the treatment of many pediatric cancers. Unfortunately, cisplatin-induced hearing loss (CIHL) is a common, clinically significant side effect with life-long ramifications, particularly for young children. ACCL05C1 and ACCL0431 are two recently completed Children's Oncology Group studies focused on the measurement and prevention of CIHL. The purpose of this paper was to gain insights from ACCL05C1 and ACCL0431, the first published cooperative group studies dedicated solely to CIHL, to inform the design of future pediatric otoprotection trials. Use of otoprotective agents is an attractive strategy for preventing CIHL, but their successful development must overcome a unique constellation of methodological challenges related to translating preclinical research into clinical trials that are feasible, evaluate practical interventions, and limit risk. Issues particularly important for children include use of appropriate methods for hearing assessment and CIHL severity grading, and use of trial designs that are well-informed by preclinical models and suitable for relatively small sample sizes. Increasing interest has made available new funding opportunities for expanding this urgently needed research.
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Affiliation(s)
| | - A. Lindsay Frazier
- Dana‐Farber Cancer Institute/Boston Children’s Hospital Cancer CenterBostonMAUSA
| | | | | | | | - Kay W. Chang
- Department of OtolaryngologyStanford UniversityPalo AltoCAUSA
| | - Mark Krailo
- Department of Preventive MedicineKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Brad H. Pollock
- Department of Public Health SciencesUniversity of CaliforniaDavisCAUSA
| | | | - David R. Freyer
- Division of Hematology, Oncology, and Blood and Bone Marrow TransplantationChildren’s Hospital Los AngelesKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
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17
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Diseases and targets for local drug delivery to the inner ear. Hear Res 2018; 368:3-9. [PMID: 29778289 DOI: 10.1016/j.heares.2018.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/06/2018] [Accepted: 05/09/2018] [Indexed: 01/09/2023]
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18
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Late Effects in Pediatric High-risk Neuroblastoma Survivors After Intensive Induction Chemotherapy Followed by Myeloablative Consolidation Chemotherapy and Triple Autologous Stem Cell Transplants. J Pediatr Hematol Oncol 2018; 40:31-35. [PMID: 28538090 DOI: 10.1097/mph.0000000000000848] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Multimodal treatment in high-risk neuroblastoma has modestly improved survival; limited data exist on the late effects from these regimens. We report the sequelae of treatment incorporating 3 consecutive cycles of high-dose therapy and autologous stem cell transplants (ASCTs) without the use of total body irradiation (TBI). We reviewed the medical records of 61 patients treated on or following the Chicago Pilot 2 protocol between 1991 and 2008. Of the 25 patients who are alive (41%), 19 had near complete data to report. Specific treatment modalities and therapy-related side effects were collected. Fourteen of these 19 patients (74%) received 3 cycles of high-dose therapy with ASCT; follow-up occurred over a median of 13.9 years (range, 5.8 to 18.8 y). The majority of late effects were endocrine-related, including growth failure, hypothyroidism, and hypogonadism. Patients also developed secondary neoplasms and skeletal deformities. The most frequent sequela was hearing loss, seen in 17/19 patients. We found a high prevalence of various late effects in survivors of high-risk neuroblastoma using a non-TBI-based regimen including 3 cycles of high-dose therapy with ASCTs. As current treatment regimens recommend tandem ASCT without TBI, it is imperative that we understand and monitor for the sequelae from these modalities.
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19
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Kraal K, Blom T, van Noesel M, Kremer L, Caron H, Tytgat G, van der Pal H. Treatment and outcome of neuroblastoma with intraspinal extension: A systematic review. Pediatr Blood Cancer 2017; 64. [PMID: 28150396 DOI: 10.1002/pbc.26451] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/20/2016] [Accepted: 12/20/2016] [Indexed: 11/09/2022]
Abstract
We performed a systematic review to define the long-term health problems and optimal treatment strategy for patients with neuroblastoma with intraspinal extension. Of 685 identified studies, 28 were included in this review. The burden of long-term health problems is high; a median of 50% of patients suffered from neurological motor deficit, 34% from sphincter dysfunction, and 30% from spinal deformity. The currently available literature remains suboptimal as a guide for treatment of NBL with intraspinal extension. More well-designed, prospective studies are needed to determine the optimal treatment strategy.
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Affiliation(s)
- Kathelijne Kraal
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands
| | - Thomas Blom
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Max van Noesel
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Leontien Kremer
- Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands
| | - Huib Caron
- Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands
| | - Godelieve Tytgat
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands
| | - Heleen van der Pal
- Department of Medical Oncology, Academic Medical Centre (AMC), Amsterdam, The Netherlands
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Brooks B, Knight K. Ototoxicity monitoring in children treated with platinum chemotherapy. Int J Audiol 2017; 57:S34-S40. [DOI: 10.1080/14992027.2017.1355570] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Beth Brooks
- Registered Audiologist, British Columbia's Children's Hospital, Vancouver, BC, Canada and
| | - Kristin Knight
- Department of Pediatric Audiology, Child Development and Rehabilitation Center, Doernbecher Children’s Hospital, Oregon Health and Science University, Portland, OR, USA
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Thiesen S, Yin P, Jorgensen AL, Zhang JE, Manzo V, McEvoy L, Barton C, Picton S, Bailey S, Brock P, Vyas H, Walker D, Makin G, Bandi S, Pizer B, Hawcutt DB, Pirmohamed M. TPMT, COMT and ACYP2 genetic variants in paediatric cancer patients with cisplatin-induced ototoxicity. Pharmacogenet Genomics 2017; 27:213-222. [PMID: 28445188 PMCID: PMC5432027 DOI: 10.1097/fpc.0000000000000281] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Cisplatin ototoxicity affects 42-88% of treated children. Catechol-O-methyltransferase (COMT), thiopurine methyltransferase (TPMT) and AYCP2 genetic variants have been associated with ototoxicity, but the findings have been contradictory. The aims of the study were as follows: (a) to investigate these associations in a carefully phenotyped cohort of UK children and (b) to perform a systematic review and meta-analysis. METHODS We recruited 149 children from seven UK centres using a retrospective cohort study design. All participants were clinically phenotyped carefully. Genotyping was performed for one ACYP2 (rs1872328), three TPMT (rs12201199, rs1142345 and rs1800460) and two COMT (rs4646316 and rs9332377) variants. RESULTS For CTCAE grading, hearing loss was present in 91/120 (75.8%; worst ear) and 79/120 (65.8%; better ear). Using Chang grading, hearing loss was diagnosed in 85/119 (71.4%; worst ear) versus 75/119 (63.0%; better ear). No TPMT or COMT single-nucleotide polymorphisms (SNPs) were associated with ototoxicity. ACYP2 SNP rs1872328 was associated with ototoxicity (P=0.027; worst ear). Meta-analysis of our data with that reported in previous studies showed the pooled odds ratio (OR) to be statistically significant for both the COMT SNP rs4646316 (OR: 1.50; 95% confidence interval: 1.15-1.95) and the ACYP2 SNP rs1872328 (OR: 5.91; 95% confidence interval: 1.51-23.16). CONCLUSION We showed an association between the ACYP2 polymorphism and cisplatin-induced ototoxicity, but not with the TPMT and COMT. A meta-analysis was statistically significant for both the COMT rs4646316 and the ACYP2 rs1872328 SNPs. Grading the hearing of children with asymmetric hearing loss requires additional clarification.
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Affiliation(s)
- Signe Thiesen
- The Wolfson Centre for Personalised Medicine, Department of Molecular and Clinical, Pharmacology, Institute of Translational Medicine, University of Liverpool. 1-5 Brownlow Street, Liverpool L69 3GL, UK
| | - Peng Yin
- Department of Biostatistics, Institute of Translational Medicine, University of Liverpool. 1-5 Brownlow Street, Liverpool, L69 3GL, UK
| | - Andrea L Jorgensen
- Department of Biostatistics, Institute of Translational Medicine, University of Liverpool. 1-5 Brownlow Street, Liverpool, L69 3GL, UK
| | - Jieying Eunice Zhang
- The Wolfson Centre for Personalised Medicine, Department of Molecular and Clinical, Pharmacology, Institute of Translational Medicine, University of Liverpool. 1-5 Brownlow Street, Liverpool L69 3GL, UK
| | - Valentina Manzo
- The Wolfson Centre for Personalised Medicine, Department of Molecular and Clinical, Pharmacology, Institute of Translational Medicine, University of Liverpool. 1-5 Brownlow Street, Liverpool L69 3GL, UK
- Dept. of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Laurence McEvoy
- The Wolfson Centre for Personalised Medicine, Department of Molecular and Clinical, Pharmacology, Institute of Translational Medicine, University of Liverpool. 1-5 Brownlow Street, Liverpool L69 3GL, UK
| | - Christopher Barton
- The Wolfson Centre for Personalised Medicine, Department of Molecular and Clinical, Pharmacology, Institute of Translational Medicine, University of Liverpool. 1-5 Brownlow Street, Liverpool L69 3GL, UK
- Department of Paediatric Oncology, Alder Hey Children's NHS Foundation Trust, Eaton Road Liverpool, L12 2AP, UK
| | - Susan Picton
- Paediatric Oncology & Haematology Department, Claredon Wing, Leeds General Infirmary, Great George St, Leeds LS1 3EX, UK
| | - Simon Bailey
- Department of Paediatric and Adolescent Haematology and Oncology, Great North Children's Hospital NHS Trust, Victoria Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
| | - Penelope Brock
- Haematology and Oncology Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK, Great Ormond Street, London, WC1N 3JH
| | - Harish Vyas
- Nottingham Children's Hospital, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK
| | - David Walker
- Nottingham Children's Hospital, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK
| | - Guy Makin
- Royal Manchester Children's Hospital NHS Trust, Oxford Rd, Manchester M13 9WL, UK
| | - Srinivas Bandi
- Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, Leicestershire, LE1 5WW, UK
| | - Barry Pizer
- The Wolfson Centre for Personalised Medicine, Department of Molecular and Clinical, Pharmacology, Institute of Translational Medicine, University of Liverpool. 1-5 Brownlow Street, Liverpool L69 3GL, UK
- Department of Paediatric Oncology, Alder Hey Children's NHS Foundation Trust, Eaton Road Liverpool, L12 2AP, UK
| | - Daniel B Hawcutt
- The Wolfson Centre for Personalised Medicine, Department of Molecular and Clinical, Pharmacology, Institute of Translational Medicine, University of Liverpool. 1-5 Brownlow Street, Liverpool L69 3GL, UK
| | - Munir Pirmohamed
- The Wolfson Centre for Personalised Medicine, Department of Molecular and Clinical, Pharmacology, Institute of Translational Medicine, University of Liverpool. 1-5 Brownlow Street, Liverpool L69 3GL, UK
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22
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Knight KR, Chen L, Freyer D, Aplenc R, Bancroft M, Bliss B, Dang H, Gillmeister B, Hendershot E, Kraemer DF, Lindenfeld L, Meza J, Neuwelt EA, Pollock BH, Sung L. Group-Wide, Prospective Study of Ototoxicity Assessment in Children Receiving Cisplatin Chemotherapy (ACCL05C1): A Report From the Children's Oncology Group. J Clin Oncol 2017; 35:440-445. [PMID: 27937095 PMCID: PMC5455699 DOI: 10.1200/jco.2016.69.2319] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose Optimal assessment methods and criteria for reporting hearing outcomes in children who receive treatment with cisplatin are uncertain. The objectives of our study were to compare different ototoxicity classification systems, to evaluate the feasibility of including otoacoustic emissions and extended high frequency audiometry, and to evaluate a central review mechanism for audiologic results for cisplatin-treated children in the cooperative group setting. Patients and Methods Eligible participants were 1 to 30 years, with planned cisplatin-containing treatment. Hearing evaluations were conducted at baseline, before each cisplatin cycle, and at the end of therapy. Audiologic results were assessed and graded by the testing audiologist and by two central review audiologists using the American Speech-Language-Hearing Association Ototoxicity Criteria (ASHA), Common Terminology Criteria for Adverse Events, version 3.0 (CTCAE), and Brock Ototoxicity Grades (Brock). One central reviewer also used the International Society of Pediatric Oncology Ototoxicity Scale (SIOP). Results At the end of treatment, the prevalence of any degree of ototoxicity ranged from 40% to 56%, and severe ototoxicity ranged from 7% to 22%. Compared with CTCAE, SIOP detected significantly more ototoxicity ( P = .004), whereas Brock criteria detected significantly fewer patients with any or severe ototoxicity ( P < .001 for both). SIOP detected ototoxicity earlier than did the other scales. Agreement between the central reviewers and the institutional audiologist was almost perfect for ASHA and Brock, whereas the poorest agreement occurred with CTCAE. Conclusion The SIOP scale may be superior to ASHA, Brock, and CTCAE scales for classifying ototoxicity in pediatric patients who were treated with cisplatin. Future studies should evaluate inter-rater reliability of the SIOP scale.
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Affiliation(s)
- Kristin R. Knight
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Lu Chen
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - David Freyer
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Richard Aplenc
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Mary Bancroft
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Bonnie Bliss
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Ha Dang
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Biljana Gillmeister
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Eleanor Hendershot
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Dale F. Kraemer
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Lanie Lindenfeld
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Jane Meza
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Edward A. Neuwelt
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Brad H. Pollock
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Lillian Sung
- Kristin R. Knight and Edward A. Neuwelt, Oregon Health and Science University, Portland, OR; Lu Chen and Ha Dang, Children’s Oncology Group, Monrovia; David Freyer, Children’s Hospital Los Angeles; Ha Dang, University of Southern California, Los Angeles; Lanie Lindenfeld, City of Hope, Duarte; Brad H. Pollock, University of California, Davis, Davis, CA; Richard Aplenc, Children’s Hospital of Philadelphia, Philadelphia, PA; Mary Bancroft, University of Florida, Gainesville; Dale F. Kraemer, University of Florida, Jacksonville, FL; Bonnie Bliss, Biljana Gillmeister, Jane Meza, and Lillian Sung, The Hospital for Sick Children, Toronto; and Eleanor Hendershot, McMaster Children’s Hospital, Hamilton, Ontario, Canada
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Dreisbach L, Ho M, Reid E, Siegel J. Effects of Oxaliplatin, Carboplatin, and Cisplatin Across Treatment on High-Frequency Objective and Subjective Auditory Measures in Adults. ACTA ACUST UNITED AC 2017. [DOI: 10.1044/persp2.sig6.17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Platinum chemotherapies are often ototoxic, initially affecting the basal end of the cochlea. Thus, monitoring high-frequency auditory function is advised to reveal early damage. Objective measures of high-frequency auditory function are repeatable over time, but the sensitivity of these measures for monitoring patients receiving platinum derivatives have not been established. We monitored 13 patients across oxaliplatin, carboplatin, or cisplatin treatment using the highest frequencies with responses for each individual. Behavioral thresholds and distortion product otoacoustic emission (DPOAE) gross frequency (f2=16–2 kHz) and concentrated frequency (1/48 octave steps at the highest frequency with a present DPOAE) sweeps were monitored. DPOAE results indicated changes during treatment within individuals using absolute change criteria, as well as statistically significant differences across trial when analyzing group data. Changes varied depending on the drug administered. Behavioral thresholds changed less often than DPOAE measures and when changes were noted, they initially occurred at the highest frequencies monitored. Often, DPOAE changes occurred at frequencies which conventional equipment could not monitor (>8 kHz). Additionally, some changes were characterized by DPOAE level enhancements at conventional frequencies (<8 kHz), while levels at higher frequencies were reduced. Overall, objective high-frequency measures were sensitive to auditory changes in adults undergoing platinum chemotherapy treatment.
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Affiliation(s)
- Laura Dreisbach
- School of Speech, Language, and Hearing Sciences, San Diego State University San Diego, CA
| | - Melissa Ho
- School of Speech, Language, and Hearing Sciences, San Diego State University San Diego, CA
| | - Erin Reid
- School of Medicine, University of California, San Diego La Jolla, CA
| | - Jonathan Siegel
- Department of Communication Sciences and Disorders, Northwestern University Evanston, IL
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Portwine C, Rae C, Davis J, Teira P, Schechter T, Lewis V, Mitchell D, Wall DA, Pullenayegum E, Barr RD. Health-Related Quality of Life in Survivors of High-Risk Neuroblastoma After Stem Cell Transplant: A National Population-Based Perspective. Pediatr Blood Cancer 2016; 63:1615-21. [PMID: 27203368 DOI: 10.1002/pbc.26063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/16/2016] [Accepted: 04/10/2016] [Indexed: 11/11/2022]
Abstract
PURPOSE This study aimed to estimate the burden of morbidity, in terms of health-related quality of life (HRQL), in survivors of high-risk neuroblastoma (NBL) after myeloablative chemotherapy followed by autologous hematopoietic stem cell transplant (HSCT). PATIENTS AND METHODS A national population-based survey was undertaken of survivors of high-risk NBL (N = 99), diagnosed between 1991 and 2010 and treated with HSCT. Parents completed a proxy questionnaire incorporating two HRQL measures, Health Utilities Index (HUI) 2 and 3. Children >12 years of age provided self-assessments. Clinical and demographic data were collected. Independent t-test and one-way analysis of variance were used to assess differences. Comparative data were obtained from previously published work and Statistics Canada's 1998 National Population Health Survey. RESULTS On a scale of 0 (being dead) to 1.0 (perfect health), mean HRQL utility scores were 0.89 (SD = 0.11) in HUI2 and 0.84 (SD = 0.18) in HUI3. Parents reported morbidity in sensation (52.5%), pain (30.3%), cognition (28.0%), and emotion (24.2%) in HUI2 and in hearing (38.4%), pain (30.3%), cognition (27.3%), and speech (23.2%) in HUI3. HRQL was not significantly different compared to NBL survivors treated without HSCT, but was less than in nontransplanted survivors of acute lymphoblastic leukemia and Wilms tumor, and children in the general population, yet higher than in survivors of brain tumors. CONCLUSIONS HRQL is compromised in high-risk NBL survivors treated with and without HSCT. A differential effect on hearing reflects additional exposure to platinum-based chemotherapy. These results should inform long-term care and the development of new therapeutic interventions.
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Affiliation(s)
- Carol Portwine
- Division of Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Charlene Rae
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jeff Davis
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Pierre Teira
- Hôpital Sainte-Justine, Montreal, Quebec, Canada
| | - Tal Schechter
- Hospital for Sick Children, Toronto, Ontario, Canada
| | - Victor Lewis
- Alberta Children's Hospital, Calgary, Alberta, Canada
| | - David Mitchell
- McGill University Health Centre, Montreal, Quebec, Canada
| | - Donna A Wall
- Pediatrics and Child Health, University of Manitoba/CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | | | - Ronald D Barr
- Division of Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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25
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Bass JK, Knight KR, Yock TI, Chang KW, Cipkala D, Grewal SS. Evaluation and Management of Hearing Loss in Survivors of Childhood and Adolescent Cancers: A Report From the Children's Oncology Group. Pediatr Blood Cancer 2016; 63:1152-62. [PMID: 26928933 PMCID: PMC5520626 DOI: 10.1002/pbc.25951] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 01/15/2016] [Accepted: 02/01/2016] [Indexed: 11/07/2022]
Abstract
Hearing loss (HL) is common in childhood cancer survivors exposed to platinum chemotherapy and/or cranial radiation and can severely impact quality of life. Early detection and appropriate management can mitigate academic, speech, language, social, and psychological morbidity resulting from hearing deficits. This review is targeted as a resource for providers involved in aftercare of childhood cancers. The goal is to promote early identification of survivors at-risk for HL, appropriate evaluation and interpretation of diagnostic tests, timely referral to an audiologist when indicated, and to increase knowledge of current therapeutic options.
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Affiliation(s)
- Johnnie K. Bass
- Rehabiliation Services, St Jude Children’s Research Hospital, Memphis, TN
| | - Kristin R. Knight
- Child Development and Rehabilitation Center, Oregon Health and Science University, Portland, OR
| | - Torunn I. Yock
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA
| | - Kay W. Chang
- Department of Otolaryngology, Stanford University, Stanford, CA
| | - Douglas Cipkala
- Center for Cancer and Blood Diseases, Peyton Manning Children’s Hospital at St. Vincent, Indianapolis, IN
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26
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Abstract
Treatment for childhood cancer with chemotherapy, radiation and/or hematopoietic cell transplant can result in adverse sequelae that may not become evident for many years. A clear understanding of the association between therapeutic exposures and specific long-term complications, and an understanding of the magnitude of the burden of morbidity borne by childhood cancer survivors, has led to the development of guidelines to support lifelong risk-based follow up for this population. It is important to develop interventions to reduce the impact of treatment-related late effects on morbidity and mortality and to continue research regarding the etiopathogenesis of therapy-related cancers and other late effects.
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Affiliation(s)
- Wendy Landier
- Department of Population Sciences, City of Hope, 1500 E. Duarte Rd., DPS-173, Duarte, CA 91010, USA
| | - Saro Armenian
- Department of Population Sciences, City of Hope, 1500 E. Duarte Rd., DPS-173, Duarte, CA 91010, USA
| | - Smita Bhatia
- Department of Population Sciences, City of Hope, 1500 E. Duarte Rd., DPS-173, Duarte, CA 91010, USA.
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27
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Risk assessment of radio-chemotherapy in pediatric soft tissue sarcomas. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2015. [DOI: 10.1016/j.jrras.2014.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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28
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Landier W, Knight K, Wong FL, Lee J, Thomas O, Kim H, Kreissman SG, Schmidt ML, Chen L, London WB, Gurney JG, Bhatia S. Ototoxicity in children with high-risk neuroblastoma: prevalence, risk factors, and concordance of grading scales--a report from the Children's Oncology Group. J Clin Oncol 2014; 32:527-34. [PMID: 24419114 PMCID: PMC3918536 DOI: 10.1200/jco.2013.51.2038] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
PURPOSE Platinum-based therapy is the mainstay for management of high-risk neuroblastoma. Prevalence of platinum-related ototoxicity has ranged from 13% to 95% in previous reports; variability is attributable to small samples and disparate grading scales. There is no consensus regarding optimal ototoxicity grading. Furthermore, prevalence and predictors of hearing loss in a large uniformly treated high-risk neuroblastoma population are unknown. We address these gaps in our study. PATIENTS AND METHODS Audiologic testing was completed after administration of cisplatin alone (< 400 mg/m(2); exposure one) or after cisplatin (400 mg/m(2)) plus carboplatin (1,700 mg/m(2); exposure two). Hearing loss was graded using four scales (American Speech-Language-Hearing Association; Brock; Chang; and Common Terminology Criteria for Adverse Events, version 3 [CTCAEv3]). RESULTS Of 489 eligible patients, 333 had evaluable audiologic data. Median age at diagnosis was 3.3 years. Prevalence of severe hearing loss differed by scale. For those in the exposure-one group, prevalence ranged from 8% per Brock to 47% per CTCAEv3 (Brock v CTCAEv3 and Chang, P < .01; CTCAEv3 v Chang, P = .16); for those in the exposure-two group, prevalence ranged from 30% per Brock to 71% per CTCAEv3 (all pair-wise comparisons, P < .01). In patients requiring hearing aids, hearing loss was graded as severe in 49% (Brock), 91% (Chang), and 100% (CTCAEv3). Risk factors for severe hearing loss included exposure to cisplatin and carboplatin compared with cisplatin alone and hospitalization for infection. CONCLUSION Severe hearing loss is prevalent among children with high-risk neuroblastoma. Exposure to cisplatin combined with myeloablative carboplatin significantly increases risk. The Brock scale underestimates severe hearing loss and should be used with caution in this setting.
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Affiliation(s)
- Wendy Landier
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
| | - Kristin Knight
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
| | - F. Lennie Wong
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
| | - Jin Lee
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
| | - Ola Thomas
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
| | - Heeyoung Kim
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
| | - Susan G. Kreissman
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
| | - Mary Lou Schmidt
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
| | - Lu Chen
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
| | - Wendy B. London
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
| | - James G. Gurney
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
| | - Smita Bhatia
- Wendy Landier, F. Lennie Wong, Jin Lee, Ola Thomas, Heeyoung Kim, and Smita Bhatia, City of Hope, Duarte; Lu Chen, Children's Oncology Group, Monrovia, CA; Kristin Knight, Oregon Health and Science University, Portland, OR; Susan G. Kreissman, Duke University Medical Center, Durham, NC; Mary Lou Schmidt, University of Illinois at Chicago, Chicago, IL; Wendy B. London, Dana-Farber/Harvard Cancer Care, Children's Hospital Boston, Boston, MA; and James G. Gurney, University of Memphis School of Public Health, Memphis, TN
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Cohen LE, Gordon JH, Popovsky EY, Gunawardene S, Duffey-Lind E, Lehmann LE, Diller LR. Late effects in children treated with intensive multimodal therapy for high-risk neuroblastoma: High incidence of endocrine and growth problems. Bone Marrow Transplant 2014; 49:502-8. [DOI: 10.1038/bmt.2013.218] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 11/22/2013] [Accepted: 11/25/2013] [Indexed: 11/09/2022]
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NITZ ALEXANDRA, KONTOPANTELIS EVANGELOS, BIELACK STEFAN, KOSCIELNIAK EWA, KLINGEBIEL THOMAS, LANGER THORSTEN, PAULIDES MARIOS. Prospective evaluation of cisplatin- and carboplatin-mediated ototoxicity in paediatric and adult soft tissue and osteosarcoma patients. Oncol Lett 2013; 5:311-315. [PMID: 23255940 PMCID: PMC3525486 DOI: 10.3892/ol.2012.997] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 07/27/2012] [Indexed: 11/05/2022] Open
Abstract
Platinum-compound chemotherapy is known to have ototoxic side-effects. However, there is a paucity of literature examining hearing function prospectively and longitudinally in cohorts containing paediatric and adult patients treated within the same cisplatin- or carboplatin-containing treatment trial protocols. In Germany, Austria and Switzerland, late effects of treatment for osteosarcoma and soft tissue sarcoma have been prospectively and longitudinally registered by the Late Effects Surveillance System since 1998. The aim of this study was to analyse cisplatin- and carboplatin-induced ototoxity in a group of 129 osteosarcoma and soft tissue sarcoma patients treated within the COSS-96, CWS-96 and CWS-2002P treatment trials. The cohort consisted of 112 children and 17 adults. The median age at diagnosis was 13.56 (IQR, 10.26-16.27) years. Follow-up was 6.97 (IQR, 0.87-15.63) months. Hearing function was examined by audiometry before and after platinum treatment. A total of 108 patients were treated with cisplatin with a median cumulative dose of 360 mg/m(2). Thirteen patients received carboplatin with a median cumulative dose of 1500 mg/m(2) and 8 patients were treated with both platinum compounds (median cisplatin dose, 240 mg/m(2); IQR, 240-360 mg/m(2) and median carboplatin dose: 1200 mg/m(2); IQR, 600-3000 mg/m(2)). Following cessation of therapy, 47.3% of the patients demonstrated a hearing impairment, namely 55 children (49.1%) and 6 adults (42.1%). Out of thirteen children treated with carboplatin with a cumulative dose of 1500 mg/m(2), six revealed a significant hearing impairment. Although ototoxicity caused by platinum compounds is considered irreversible, we identified hearing improvements over time in 11 children (9.8%) and 3 adults (17.6%). None of these patients received irradiation to the head. We conclude that hearing loss is frequent in children treated with protocols containing platinum compounds and recommend prospective testing via audiometry.
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Affiliation(s)
- ALEXANDRA NITZ
- Department of Paediatric Oncology and Immunology, LESS Centre, University Hospital for Children and Adolescents, Erlangen D-91054,
Germany
| | - EVANGELOS KONTOPANTELIS
- Department of Community Based Medicine (Health Sciences Research Group - Primary Care), University of Manchester, Manchester, M13 9PL,
UK
| | - STEFAN BIELACK
- Department of Oncology, Haematology, Immunology, General Pediatrics, Gastroenterology, Rheumatology (COSS Study), Klinikum Stuttgart - Olgahospital, Stuttgart D-70176
| | - EWA KOSCIELNIAK
- Department of Oncology, Haematology, Immunology, General Pediatrics, Gastroenterology, and Rheumatology (CWS study), Klinikum Stuttgart - Olgahospital, Stuttgart D-70176
| | - THOMAS KLINGEBIEL
- Department of Paediatric Haematology, Oncology and Haemostaseology, Universitaetsklinikum Frankfurt - Johann-Wolfgang-Goethe-University, Frankfurt D-60596,
Germany
| | - THORSTEN LANGER
- Department of Paediatric Oncology and Immunology, LESS Centre, University Hospital for Children and Adolescents, Erlangen D-91054,
Germany
| | - MARIOS PAULIDES
- Department of Paediatric Oncology and Immunology, LESS Centre, University Hospital for Children and Adolescents, Erlangen D-91054,
Germany
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Dalian D, Haiyan J, Yong F, Salvi R, Someya S, Tanokura M. OTOTOXIC EFFECTS OF CARBOPLATIN IN ORGANOTYPIC CULTURES IN CHINCHILLAS AND RATS. J Otol 2012; 7:92-101. [PMID: 25593588 DOI: 10.1016/s1672-2930(12)50023-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Carboplatin, a second-generation platinum chemotherapeutic drug, is considerably less ototoxic than cisplatin. While common laboratory species such as mice, guinea pigs and rats are highly resistant to carboplatin ototoxicity, the chinchilla stands out as highly susceptible. Moreover, carboplatin causes an unusual gradient of cell death in chinchillas. Moderate doses selectively damage type I spiral ganglion neurons (SGN) and inner hair cells (IHC) and the lesion tends to be relatively uniform along the length of the cochlea. Higher doses eventually damage outer hair cells (OHC), but the lesion follows the traditional gradient in which damage is more severe in the base than the apex. While carboplatin ototoxicity has been well documented in adult animals in vivo, little is known about its in vitro toxicity. To elucidate the ototoxic effects of carboplatin in vitro, we prepared cochlear and vestibular organotypic cultures from postnatal day 3 rats and adult chinchillas. Chinchilla cochlear and vestibular cultures were treated with carboplatin concentrations ranging from 50 µM to 10 mM for 48 h. Consistent with in vivo data, carboplatin selectively damaged IHC at low concentrations (50-100 µM). Surprisingly, IHC loss decreased at higher doses and IHC were intact at doses exceeding 500 µM. The mechanisms underlying this nonlinear response are unclear but could be related to a decrease in carboplatin uptake via active transport mechanisms (e.g., copper). Unlike the cochlea, the carboplatin dose-response function increased with dose with the highest dose destroying all chinchilla vestibular hair cells. Cochlear hair cells and auditory nerve fibers in rat cochlear organotypic cultures were unaffected by carboplatin concentrations <10 µM; however, the damage in OHC were more severe than IHC once the dose reached 100 µM. A dose at 500 µM destroyed all the cochlear hair cells, but hair cell loss decreased at high concentrations and nearly all the cochlear hair cells were present at the highest dose, 5 mM. Unlike the nonlinear dose-response seen with cochlear hair cells, rat auditory nerve fiber and spiral ganglion losses increased with doses above 50 µM with the highest dose destroying virtually all SGN. The remarkable species differences seen in vitro suggest that chinchilla IHC and type I SGN posse some unique biological mechanism that makes them especially vulnerable to carboplatin toxicity.
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Affiliation(s)
- Ding Dalian
- Center for Hearing and Deafness, State University of New York at Buffalo ; Graduate School of Agricultural and Life Sciences, University of Tokyo
| | - Jiang Haiyan
- Center for Hearing and Deafness, State University of New York at Buffalo
| | - Fu Yong
- Center for Hearing and Deafness, State University of New York at Buffalo
| | - Richard Salvi
- Center for Hearing and Deafness, State University of New York at Buffalo
| | - Shinichi Someya
- Departments of Aging and Geriatric Research, Division of Biology of Aging, University of Florida
| | - Masaru Tanokura
- Graduate School of Agricultural and Life Sciences, University of Tokyo
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Bhagat S, Bass J, Qaddoumi I, Brennan R, Wilson M, Wu J, Galindo CR, Paglialonga A, Tognola G. Time-frequency analysis of transient-evoked otoacoustic emissions in children exposed to carboplatin chemotherapy. Audiol Neurootol 2012; 18:71-82. [PMID: 23147804 PMCID: PMC3777667 DOI: 10.1159/000343909] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 10/01/2012] [Indexed: 01/10/2023] Open
Abstract
The aims of this study were to characterize and quantify time-frequency changes in transient-evoked otoacoustic emissions (TEOAEs) recorded in children diagnosed with retinoblastoma who were receiving carboplatin chemotherapy. A signal processing technique, the wavelet transform (WT), was used to analyze TEOAE waveforms in narrow-band frequency components. Ten children (aged 3-72 months) diagnosed with unilateral or bilateral retinoblastoma were enrolled in the study. TEOAEs were acquired from the children with linear sequences of 70 dB peak equivalent SPL clicks. After WT analysis, TEOAE energy, latency and normalized energy in the narrow-band frequency components were compared before and during carboplatin chemotherapy treatment (average dose 1693 mg/m2). On a group basis, no significant differences (p>0.05) in the TEOAE energy, latency or normalized energy before and after carboplatin treatment were observed. There were decreases in normalized energy on an individual basis in 10 out of 18 ears in the sample. Exposure to carboplatin chemotherapy did not cause significant changes in TEOAE energy, latency and normalized energy during treatment. However, long-term monitoring of hearing with measurements of TEOAEs is warranted, given the risks of delayed hearing loss in some children receiving carboplatin chemotherapy.
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Affiliation(s)
- Shaum Bhagat
- Hearing Science Laboratory, School of Communication Sciences and Disorders, The University of Memphis, and St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
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Peterson CC, Cousino MK, Donohue JE, Schmidt ML, Gurney JG. Discordant Parent Reports of Family Functioning Following Childhood Neuroblastoma: A Report from the Children's Oncology Group. J Psychosoc Oncol 2012; 30:503-18. [DOI: 10.1080/07347332.2012.703766] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Yancey A, Harris MS, Egbelakin A, Gilbert J, Pisoni DB, Renbarger J. Risk factors for cisplatin-associated ototoxicity in pediatric oncology patients. Pediatr Blood Cancer 2012; 59:144-8. [PMID: 22431292 PMCID: PMC3767972 DOI: 10.1002/pbc.24138] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 02/20/2012] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cisplatin is an effective chemotherapy agent against several pediatric malignancies. One of its side effects is irreversible sensorineural hearing damage that is highly variable with a reported incidence of 22-70%. The aim of this study was to evaluate the incidence and identify clinical predictors of cisplatin-related ototoxicity. PROCEDURES We performed a retrospective chart review of 102 pediatric patients who had completed cisplatin therapy for osteosarcoma, neuroblastoma, hepatoblastoma, or germ cell tumor. Patients were diagnosed at Riley Hospital for Children between January 1995 and June 2008, were less than 18 years old at diagnosis, and had normal hearing prior to therapy. Audiograms were scored using the Brock scale (0-4), a validated grading system for cisplatin-related hearing loss. RESULTS Forty-two percent of the patients experienced hearing loss and 28% had moderate to severe ototoxicity (Brock score ≥2). Males were at significantly greater risk for developing hearing loss than were females (P = 0.005, OR 4.812). Age at cancer diagnosis was inversely related to severity of ototoxicity. Patients who suffered Brock grade 3 ototoxicity had a mean age of 4.5 years versus 11.5 years and 7.2 years for grades 1 and 2, respectively (P = 0.02). Cumulative cisplatin dose was also identified as a risk factor for development of ototoxicity (P = 0.03). CONCLUSIONS Gender and cumulative dose are important clinical biomarkers of cisplatin ototoxicity. Severity of ototoxicity may be inversely related to age at time of exposure, with very young patients exhibiting higher grades of hearing loss following cisplatin therapy.
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Affiliation(s)
- Allison Yancey
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
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Glotzbecker B, Duncan C, Alyea E, Campbell B, Soiffer R. Important Drug Interactions in Hematopoietic Stem Cell Transplantation: What Every Physician Should Know. Biol Blood Marrow Transplant 2012; 18:989-1006. [DOI: 10.1016/j.bbmt.2011.11.029] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Accepted: 11/23/2011] [Indexed: 10/14/2022]
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Gurney JG, Bass JK. New International Society of Pediatric Oncology Boston Ototoxicity Grading Scale for pediatric oncology: still room for improvement. J Clin Oncol 2012; 30:2303-6. [PMID: 22547588 DOI: 10.1200/jco.2011.41.3187] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Perwein T, Lackner H, Sovinz P, Benesch M, Schmidt S, Schwinger W, Urban C. Survival and late effects in children with stage 4 neuroblastoma. Pediatr Blood Cancer 2011; 57:629-35. [PMID: 21319289 DOI: 10.1002/pbc.23036] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 12/21/2010] [Indexed: 12/21/2022]
Abstract
BACKGROUND Treatment of metastatic neuroblastoma (NB) demands aggressive oncological therapy, which may cause long-term sequelae in survivors. The aim of this retrospective single center study is to give an overview of survival in children with stage 4 NB and to describe the spectrum of late effects seen in survivors. PROCEDURE Medical records of 31 patients with stage 4 NB treated between 1984 and 2009, who were included in a follow-up programme, were reviewed for information on tumor, treatment and late effects. RESULTS Five-year overall survival was 54.3 ± 9% and 5-year event-free survival was 44.9 ± 9%. Patients diagnosed after 1996 had a significantly better survival rate than those diagnosed before (74 ± 11.2% vs. 33.3 ± 12.2%, P = 0.011). In 15 of the 16 survivors (93.8%), numerous late effects were detected. The most common long-term sequelae were renal changes in 10 patients (62.5%) and endocrine disturbances in 9 patients (56.3%), including hypothyroidism with need of substitution in 50%, GH deficiency in 37.5% and hypogonadism in 12.5%. Sensorineural hearing loss occurred in 37.5% of survivors. Further observed late effects were hepatobiliary changes (31.3%), musculoskeletal problems, and pulmonary abnormalities (each 25%), as well as neurologic changes (18.8%), dental defects (12.5%), and unilateral blindness (6.3%). Second neoplasms appeared in 3 patients, 1 of whom died of hepatocellular carcinoma following infection with hepatitis B. CONCLUSIONS More than 50% of children with stage 4 NB may survive. The high incidence of severe long-term sequelae underlines the importance of careful follow-up in order to detect and treat late effects early enough.
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Affiliation(s)
- Thomas Perwein
- Division of Paediatric Haematology/Oncology, Medical University of Graz, Graz, Austria.
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Bhagat SP, Bass JK, White ST, Qaddoumi I, Wilson MW, Wu J, Rodriguez-Galindo C. Monitoring carboplatin ototoxicity with distortion-product otoacoustic emissions in children with retinoblastoma. Int J Pediatr Otorhinolaryngol 2010; 74:1156-63. [PMID: 20667604 PMCID: PMC4787621 DOI: 10.1016/j.ijporl.2010.07.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Revised: 06/30/2010] [Accepted: 07/02/2010] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Carboplatin is a common chemotherapy agent with potential ototoxic side effects that is used to treat a variety of pediatric cancers, including retinoblastoma. Retinoblastoma is a malignant tumor of the retina that is usually diagnosed in young children. Distortion-product otoacoustic emission tests offer an effective method of monitoring for ototoxicity in young children. This study was designed to compare measurements of distortion-product otoacoustic emissions obtained before and after several courses of carboplatin chemotherapy in order to examine if (a) mean distortion-product otoacoustic emission levels were significantly different; and (b) if criterion reductions in distortion-product otoacoustic emission levels were observed in individual children. METHODS A prospective repeated measures study. Ten children with a median age of 7.6 months (range, 3-72 months) diagnosed with unilateral or bilateral retinoblastoma were examined. Distortion-product otoacoustic emissions were acquired from both ears of the children with 65/55 dB SPL primary tones (f(2)=793-7996 Hz) and a frequency resolution of 3 points/octave. Distortion-product otoacoustic emission levels in dB SPL were measured before chemotherapy treatment (baseline measurement) and after 3-4 courses of chemotherapy (interim measurement). Comparisons were made between baseline and interim distortion-product otoacoustic emission levels (collapsed across ears). Evidence of ototoxicity was based on criterion reductions (≥ 6 dB) in distortion-product otoacoustic emission levels. RESULTS Significant differences between baseline and interim mean distortion-product otoacoustic emission levels were only observed at f(2) = 7996 Hz. Four children exhibited criterion reductions in distortion-product otoacoustic emission levels. CONCLUSIONS Mean distortion-product otoacoustic emission levels at most frequencies were not changed following 3-4 courses of carboplatin chemotherapy in children with retinoblastoma. However, on an individual basis, children receiving higher doses of carboplatin exhibited criterion reductions in distortion-product otoacoustic emission level at several frequencies. These findings suggest that higher doses of carboplatin affect outer hair cell function, and distortion-product otoacoustic emission tests can provide useful information when monitoring children at risk of developing carboplatin ototoxicity.
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Affiliation(s)
- Shaum P Bhagat
- School of Audiology and Speech-Language Pathology, The University of Memphis, Memphis, TN, United States.
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40
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Grewal S, Merchant T, Reymond R, McInerney M, Hodge C, Shearer P. Auditory late effects of childhood cancer therapy: a report from the Children's Oncology Group. Pediatrics 2010; 125:e938-50. [PMID: 20194279 PMCID: PMC3106205 DOI: 10.1542/peds.2009-1597] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Children treated for malignancies may be at risk for early- or delayed-onset hearing loss that can affect learning, communication, school performance, social interaction, and overall quality of life. Survivors at particular risk include those treated with platinum compounds (cisplatin and/or carboplatin) for neuroblastoma, hepatoblastoma, osteosarcoma, or germ-cell tumors and/or those treated with radiation that affects the ear at doses of >30 Gy for pediatric head and neck tumors. The aims of the Auditory/Hearing Late Effects Task Force of the Children's Oncology Group in this report were to (1) review ototoxicity resulting from childhood cancer therapy including platinum compounds (cisplatin and carboplatin) and radiation, (2) describe briefly cochlear pathophysiology and genetics of cisplatin-related hearing loss, (3) explain the impact of hearing loss resulting from chemotherapy and radiation, and (4) offer recommendations regarding evaluation and management of pediatric patients who are at risk for treatment-related hearing loss. A questionnaire is included as a tool to assist pediatricians in assessment.
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Affiliation(s)
- Satkiran Grewal
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Baystate Medical Center, Springfield, Massachusetts, USA
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Chang KW, Chinosornvatana N. Practical grading system for evaluating cisplatin ototoxicity in children. J Clin Oncol 2010; 28:1788-95. [PMID: 20194861 DOI: 10.1200/jco.2009.24.4228] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We present a new ototoxicity grading system that has clearly defined and frequency-specific audiometric criteria. The purpose of this study was to validate this grading system by assessing its correspondence to audiology treatment recommendations and comparing it with the currently utilized Common Terminology Criteria for Adverse Events (CTCAE). PATIENTS AND METHODS A retrospective chart review was conducted using audiologic, demographic, and clinical data from 134 children receiving 149 courses of chemotherapy consisting of cisplatin and/or carboplatin. Pure-tone audiograms were evaluated using both our proposed grading criteria and the CTCAE criteria. The resulting grades were then compared with charted audiologic interventions and a number of clinical parameters to assess the clinical validity of the grading scale. RESULTS Chang grade 2a or higher predicted audiologic intervention. Although both the Chang and CTCAE ototoxicity grades were significantly related to audiologist recommendations for assistive devices such as hearing aids and/or frequency modulated systems (P < .0001), the Chang scale was more specific, with the CTCAE scale diverging from clinical recommendation at higher grades. As expected, patients receiving cisplatin had more severe hearing loss with concurrent carboplatin administration, radiation therapy exposure, younger age, smaller body-surface area, longer treatment exposure, and more severe disease. CONCLUSION This grading system provides robust and clinically useful criteria to represent clinical hearing loss induced by ototoxicity with regard to the impact on speech and language and the need for assistive hearing devices. It is both more specific and more sensitive than the traditional CTCAE criteria for identifying clinically significant ototoxicity.
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Affiliation(s)
- Kay W Chang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
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Jang HJ, Cho HR, Lee JH, Bae KY, Seo JJ, Moon HN, Im HJ. Ototoxicity in children receiving cisplatin chemotherapy. KOREAN JOURNAL OF PEDIATRICS 2010. [DOI: 10.3345/kjp.2010.53.2.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hee Jin Jang
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hyung Rae Cho
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jae Hee Lee
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kun Yuk Bae
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jong Jin Seo
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hyung Nam Moon
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ho Joon Im
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Gheeya JS, Chen QR, Benjamin CD, Cheuk AT, Tsang P, Chung JY, Metaferia BB, Badgett TC, Johansson P, Wei JS, Hewitt SM, Khan J. Screening a panel of drugs with diverse mechanisms of action yields potential therapeutic agents against neuroblastoma. Cancer Biol Ther 2009; 8:2386-95. [PMID: 19946221 DOI: 10.4161/cbt.8.24.10184] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Neuroblastoma (NB) is the most common extracranial solid tumor in children. Despite current aggressive therapy, the survival rate for high risk NB remains less than 40%. To identify novel effective chemo-agents against NB, we screened a panel of 96 drugs against two NB cell lines, SK-N-AS and SH-SY5Y. We found 30 compounds that were active against NB cell lines at < or =10 microM concentration. More interestingly, 17 compounds are active at < or =1 microM concentration, and they act through a wide spectrum of diverse mechanisms such as mitotic inhibition, topoisomerase inhibition, targeting various biological pathways, and unknown mechanisms. The majority of these active compounds also induced caspase 3/7 by more than 2-fold. Of these 17 active compounds against NB cell lines at sub-micromolar concentration, eleven compounds are not currently used to treat NB. Among them, nine are FDA approved compounds, and three agents are undergoing clinical trials for various malignancies. Furthermore, we identified four agents active against these NB cell lines that have not yet been tested in the clinical setting. Finally we demonstrated that Cucurbitacin I inhibits neuroblastoma cell growth through inhibition of STAT3 pathway. These drugs thus represent potential novel therapeutic agents for patients with NB, and further validation studies are needed to translate them to the clinic.
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Affiliation(s)
- Jinesh S Gheeya
- Oncogenomics Section, Pediatric Oncology Branch, Advanced Technology Center, National Cancer Institute, Gaithersburg, MD, USA
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Laverdière C, Liu Q, Yasui Y, Nathan PC, Gurney JG, Stovall M, Diller LR, Cheung NK, Wolden S, Robison LL, Sklar CA. Long-term outcomes in survivors of neuroblastoma: a report from the Childhood Cancer Survivor Study. J Natl Cancer Inst 2009; 101:1131-40. [PMID: 19648511 DOI: 10.1093/jnci/djp230] [Citation(s) in RCA: 126] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The 5-year survival rate for individuals with neuroblastoma is approaching 70%. Few data exist, however, on the long-term outcomes of these patients, who are often treated at a very young age. METHODS Outcome data were obtained for 954 5-year neuroblastoma survivors who were diagnosed in 1970-1986 and enrolled in the Childhood Cancer Survivor Study (CCSS). Late mortality, second malignant neoplasms, and chronic health conditions were analyzed in relation to treatment factors using Poisson regression models and their modification with generalized estimating equations. Neuroblastoma survivors were compared with a cohort of 3899 siblings of CCSS participants for risk of chronic health conditions and selected sociodemographic outcomes. All statistical tests were two-sided. RESULTS Six percent of patients died more than 5 years after their diagnosis (standardized mortality ratio = 5.6; 95% confidence interval [CI] = 4.4 to 6.9). The most common causes of death were disease recurrence (n = 43) and second malignant neoplasms (n = 13). The cumulative incidence of second malignant neoplasms was 3.5% at 25 years and 7.0% at 30 years after diagnosis. Compared with the sibling cohort, survivors had an increased risk of selected chronic health conditions (risk ratio [RR] = 8.3; 95% CI = 7.1 to 9.7) with a 20-year cumulative incidence of 41.1%. The most prevalent outcomes involved the neurological, sensory, endocrine, and musculoskeletal systems, with 20-year cumulative incidences of 29.8%, 8.6%, 8.3%, and 7.8%, respectively. Neuroblastoma survivors who were treated with multimodality therapy were more likely to develop a chronic health condition than survivors treated with surgery alone (RR = 2.2; 95% CI = 1.6 to 3.0). Neuroblastoma survivors were less likely than siblings to have ever been employed (P = .04) or to be married (P < .001) and had a lower personal income (P = .009). CONCLUSIONS Neuroblastoma survivors have an increased rate of mortality and second malignant neoplasms, relative to the age- and sex-comparable US population, and of chronic health conditions, relative to their siblings, which underscores the need for long-term medical surveillance.
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Dhooge I, Dhooge C, Geukens S, De Clerck B, De Vel E, Vinck BM. Distortion product otoacoustic emissions: An objective technique for the screening of hearing loss in children treated with platin derivatives. Int J Audiol 2009; 45:337-43. [PMID: 16777780 DOI: 10.1080/14992020600582117] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In order to develop a sensitive audiometric protocol for identifying ototoxicity in children, a retrospective study of 16 children treated with cisplatin and/or carboplatin was performed. Audiometric testing was done by means of pure-tone threshold audiometry (PTA), high-frequency audiometry (HFA), and distortion product otoacoustic emissions (DPOAEs). Cisplatin caused a sensorineural high-frequency hearing loss in the study group compared to the controls (p < 0.01). Sixty-six percent of the cisplatin patients had a grade 2 or 3 ototoxicity. However, ototoxicity was not found in the patients treated with carboplatin. An excellent correlation was found between DPOAE levels and results obtained by audiometry (r = 0.82). Patients exposed to cisplatin are at significant risk for the development of drug-induced sensorineural hearing loss. Because of the several advantages of DPOAEs (noninvasive, objective, rapid, easy to use, sensitive) this method should be added in the audiological follow-up in infants and toddlers.
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Affiliation(s)
- Ingeborg Dhooge
- ENT Department, Department of Pediatric Hematology and Oncology, Ghent University Hospital, Ghent, Belgium.
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Sheinfeld Gorin S, McAuliffe P. Implications of childhood cancer survivors in the classroom and the school. HEALTH EDUCATION 2008. [DOI: 10.1108/09654280910923363] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Factors Affecting Sensitivity of Distortion-Product Otoacoustic Emissions to Ototoxic Hearing Loss. Ear Hear 2008; 29:875-93. [DOI: 10.1097/aud.0b013e318181ad99] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hobbie WL, Moshang T, Carlson CA, Goldmuntz E, Sacks N, Goldfarb SB, Grupp SA, Ginsberg JP. Late effects in survivors of tandem peripheral blood stem cell transplant for high-risk neuroblastoma. Pediatr Blood Cancer 2008; 51:679-83. [PMID: 18623215 PMCID: PMC2888471 DOI: 10.1002/pbc.21683] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Increasing numbers of children with advanced neuroblastoma are achieving cure. We describe the clinical late effects specific to survivors of stage IV neuroblastoma all similarly treated using tandem autologous peripheral blood stem cell rescue with TBI. METHOD The medical records of 35 neuroblastoma patients treated at CHOP between 1997 and 2001 were examined. Eighteen of the 35 patients died of progressive disease, and 4 were lost to follow-up. Thirteen patients continue to follow-up in our Multidisciplinary Cancer Survivorship Clinic where they are evaluated and monitored by a consistent group of subspecialists that evaluate long-term sequelae. Data on treatment exposures including TBI and treatment related sequelae identified by clinician assessment and/or diagnostic testing were collected. RESULTS Results indicate late effects were present in all 13 subjects, 12 of whom suffered from multiple negative sequelae, including issues with growth hormone deficiency, dental problems, osteochondromas and hearing deficiencies, among others, most at higher rates than reported previously. CONCLUSIONS The findings in this small cohort indicate the need for future prospective studies of this intensive pediatric cancer treatment, and underscore the importance of medical intervention and long-term monitoring of these at-risk subjects to increase overall quality-of-life.
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Affiliation(s)
- Wendy L Hobbie
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Geoerger B, Doz F, Gentet JC, Mayer M, Landman-Parker J, Pichon F, Chastagner P, Rubie H, Frappaz D, Le Bouil A, Gupta S, Vassal G. Phase I Study of Weekly Oxaliplatin in Relapsed or Refractory Pediatric Solid Malignancies. J Clin Oncol 2008; 26:4394-400. [DOI: 10.1200/jco.2008.16.7585] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To explore feasibility, maximum-tolerated dose (MTD), and recommended dose (RD) for phase II studies of weekly oxaliplatin for the treatment of relapsed or refractory pediatric solid malignancies. Patients and Methods Eligible patients were 6 months to 21 years old, had a diagnosis of a solid malignancy, and had experienced treatment failure with at least two or more previous lines of therapy. The phase I study was multicentric, open-label, and nonrandomized. It foresaw two phases: a dose-escalation phase (comprising six levels) to find the RD and an extension at the RD to evaluate the cumulative toxicity. Oxaliplatin was administered intravenously over 2 hours on days 1, 8, and 15 of a 28-day cycle. Results Forty-five patients were enrolled: 29 patients in the dose-escalation phase and 16 patients in the extension at the RD. Median age was 9.5 years (range, 2.8 to 20.0 years) and 7.8 years (range, 1.8 to 19.2 years), respectively. The dose-limiting toxicities during the first treatment cycle were grade 3 (G3) sepsis at 50 mg/m2, G3 dysesthesia at 90 mg/m2, and G3 dysesthesia and G3 paresthesia at 110 mg/m2, thus the MTD and RD was 90 mg/m2. No case of ototoxicity was reported. Stable disease was reported in seven patients (16.3%), and confirmed partial response was observed in two patients (4.7%), one with neuroblastoma and one with osteosarcoma. Conclusion Oxaliplatin administered in a weekly schedule has an acceptable safety profile, different from cisplatin and carboplatin, and shows activity in children with relapsed or refractory solid tumors, suggesting further investigation in pediatric malignancies.
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Affiliation(s)
- Birgit Geoerger
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
| | - François Doz
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
| | - Jean-Claude Gentet
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
| | - Michele Mayer
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
| | - Judith Landman-Parker
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
| | - Fabienne Pichon
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
| | - Pascal Chastagner
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
| | - Hervé Rubie
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
| | - Didier Frappaz
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
| | - Anne Le Bouil
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
| | - Sunil Gupta
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
| | - Gilles Vassal
- From the Institut Gustave-Roussy, Villejuif; Institut Curie, Hopital Saint-Vincent de Paul, and Hopital Trousseau, Paris; Hopital de la Timone, Marseille; Centre Oscar Lambret, Lille; Hopital d’Enfants, Nancy; Hopital Purpan, Toulouse; Centre Léon Bérard, Lyon; Centre Hospitalier Universitaire, Angers, France; and Sanofi-aventis, Malvern, PA
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Strunk CJ, Alexander SW. Solid Tumors of Childhood. Oncology 2007. [DOI: 10.1007/0-387-31056-8_62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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