1
|
Murphy B, Jackson A, Bass JK, Tsang DS, Ronckers CM, Kremer L, Baliga S, Olch A, Zureick AH, Jee KW, Constine LS, Yock TI. Modeling the Risk of Hearing Loss From Radiation Therapy in Childhood Cancer Survivors: A PENTEC Comprehensive Review. Int J Radiat Oncol Biol Phys 2024; 119:446-456. [PMID: 37855793 DOI: 10.1016/j.ijrobp.2023.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/28/2023] [Accepted: 08/06/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE The Pediatric Normal Tissue Effects in the Clinic (PENTEC) hearing loss (HL) task force reviewed investigations on cochlear radiation dose-response relationships and risk factors for developing HL. Evidence-based dose-response data are quantified to guide treatment planning. METHODS AND MATERIALS A systematic review of the literature was performed to correlate HL with cochlear dosimetry. HL was considered present if a threshold exceeded 20 dB at any frequency. Radiation dose, ototoxic chemotherapy exposure, hearing profile including frequency spectra, interval to HL, and age at radiation therapy (RT) were analyzed. RESULTS Literature was systematically reviewed from 1970 to 2021. This resulted in 739 abstracts; 19 met inclusion for meta-analysis, and 4 included data amenable to statistical modeling. These 4 studies included 457 cochleas at risk in patients treated with RT without chemotherapy, and 398 cochlea treated with chemotherapy. The incidence and severity of cochlear HL from RT exposure alone is related to dose and age. Risk of HL was <5% in cochlea receiving a mean dose ≤35 Gy but increased to 30% at 50 Gy. HL risk ranged from 25% to 40% in children under the age of 5 years at diagnosis, declining to 10% in older children for any radiation dose. Probability of similar severe HL occurred at doses 18.3 Gy higher for children <3 versus >3 years of age. High-frequency HL was most common, with average onset occurring 3.6 years (range, 0.4-13.2 years) after RT. Exposure to platinum-based chemotherapies added to the rates of HL at a given cochlear dose level, with 300 mg/m2 shifting the dose response by 7 Gy. CONCLUSIONS In children treated with RT alone, risk of HL was low for cochlear dose <35 Gy and rose when dose exceeded 35 Gy without clear RT dose dependence. High-frequency HL was most prevalent, but all frequencies were affected. Children younger than 5 years were at highest risk of developing HL, although independent effects of dose and age were not fully elucidated. Future reports with more granular data are needed to better delineate time to onset of HL and the effects of chemoradiotherapy.
Collapse
Affiliation(s)
- Blair Murphy
- Department of Radiation Medicine, Oregon Health & Science University, Doernbecher Children's Hospital, Portland, Oregon.
| | - Andrew Jackson
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Johnnie K Bass
- Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Derek S Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Cecile M Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands; Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
| | - Leontien Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Emma Children's Hospital, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Sujith Baliga
- Ohio State University Medical Center, Columbus, Ohio
| | - Arthur Olch
- University of Southern California, Children's Hospital of Los Angeles, Los Angeles, California
| | | | | | - Louis S Constine
- Departments of Radiation Oncology and Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Torunn I Yock
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
2
|
Bass JK, Wang F, Thaxton ME, Warren SE, Srivastava DK, Hudson MM, Ness KK, Brinkman TM. Association of hearing loss with patient-reported functional outcomes in adult survivors of childhood cancer. J Natl Cancer Inst 2024; 116:596-605. [PMID: 38048603 PMCID: PMC10995849 DOI: 10.1093/jnci/djad250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Hearing loss is prevalent following ototoxic therapy for childhood cancer. Associations between hearing loss, self-perceived hearing handicap, and functional outcomes have not been examined in survivors. METHODS Adult survivors treated with platinum or head and neck radiotherapy with hearing loss were recruited. A total of 237 survivors (median age at survey = 37.0 years [range = 30.0-45.0 years]; median = 29.1 years [range = 22.4-35.0 years] since diagnosis; median = 4.0 years [range = 2.9-7.7 years] from last audiogram to survey) completed the Hearing Handicap Inventory for Adults and questionnaires on social and emotional functioning and hearing aid use. Hearing loss severity was defined according to Chang criteria. Multivariable logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between hearing loss, hearing handicap, functional outcomes, and hearing aid use with adjustment for sex, race, age at hearing loss diagnosis, and age at survey. RESULTS Two-thirds of survivors had severe hearing loss, which was associated with increased likelihood of hearing handicap (mild-moderate handicap: OR = 2.72, 95% CI = 1.35 to 5.47; severe handicap: OR = 5.99, 95% CI = 2.72 to 13.18). Survivors with severe hearing handicap had an increased likelihood of social isolation (OR = 8.76, 95% CI = 3.62 to 21.20), depression (OR = 9.11, 95% CI = 3.46 to 24.02), anxiety (OR = 17.57, 95% CI = 3.77 to 81.84), reduced personal income (OR = 2.82, 95% CI = 1.46 to 5.43), and less than full-time employment (OR = 2.47, 95% CI = 1.30 to 4.70). Survivors who did not use a recommended hearing aid were twice as likely to have less than full-time employment (OR = 2.26, 95% CI = 1.10 to 4.61) and reduced personal income (OR = 2.24, 95% CI = 1.08 to 4.63) compared with survivors who wore a hearing aid. CONCLUSION Self-perceived hearing handicap beyond measured hearing loss is associated with reduced functional outcomes. Assessment of hearing handicap may facilitate targeted interventions in adult survivors with hearing loss.
Collapse
Affiliation(s)
- Johnnie K Bass
- Rehabilitation Services, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Fang Wang
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | | | - Sarah E Warren
- School of Communication Sciences and Disorders, University of Memphis, Memphis, TN, USA
| | - Deo Kumar Srivastava
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Psychology and Biobehavioral Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA
| |
Collapse
|
3
|
Mendel LL, Pousson MA, Jones SE, Bass JK. Validation of Male Talker Recordings of the Spanish Pediatric Speech Recognition Threshold Test and the Spanish Pediatric Picture Identification Test. Am J Audiol 2022; 31:1143-1154. [PMID: 36001819 DOI: 10.1044/2022_aja-21-00276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to validate recordings of the Spanish Pediatric Speech Recognition Threshold (SPSRT) test and Spanish Pediatric Picture Identification Test (SPPIT) for Spanish-speaking children using a native, bilingual Spanish-English male talker of Castilian peninsular dialect from Spain. METHOD Seventy native Spanish-speaking children from a variety of countries participated. Fifty-eight participants had normal hearing, and the remaining 12 had mild hearing loss in at least one ear. Male talker recordings of the SPSRT and SPPIT were administered to obtain baseline validation data. Participants listened to the stimuli and pointed to the appropriate item on the picture boards that represented the word they heard. RESULTS Mean SRTs were within 5 dB of mean pure-tone averages resulting in a positive correlation. Performance-intensity functions for the SPPIT showed minimal significant differences across the three test lists, and performance increased as the sensation level increased. CONCLUSIONS The male talker recordings of the SPSRT and SPPIT are valid speech perception picture-pointing assessments that can be used with Spanish-speaking children. The recordings present the Spanish target word while simultaneously presenting the English interpretation for ease of scoring.
Collapse
Affiliation(s)
- Lisa Lucks Mendel
- School of Communication Sciences and Disorders, The University of Memphis, TN
| | - Monique A Pousson
- School of Communication Sciences and Disorders, The University of Memphis, TN
| | - Skye E Jones
- Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN
| | - Johnnie K Bass
- Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN
| |
Collapse
|
4
|
Michalski JM, Janss AJ, Vezina LG, Smith KS, Billups CA, Burger PC, Embry LM, Cullen PL, Hardy KK, Pomeroy SL, Bass JK, Perkins SM, Merchant TE, Colte PD, Fitzgerald TJ, Booth TN, Cherlow JM, Muraszko KM, Hadley J, Kumar R, Han Y, Tarbell NJ, Fouladi M, Pollack IF, Packer RJ, Li Y, Gajjar A, Northcott PA. Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy With Chemotherapy for Newly Diagnosed Average-Risk Medulloblastoma. J Clin Oncol 2021; 39:2685-2697. [PMID: 34110925 DOI: 10.1200/jco.20.02730] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Children with average-risk medulloblastoma (MB) experience survival rates of ≥ 80% at the expense of adverse consequences of treatment. Efforts to mitigate these effects include deintensification of craniospinal irradiation (CSI) dose and volume. METHODS ACNS0331 (ClinicalTrials.gov identifier: NCT00085735) randomly assigned patients age 3-21 years with average-risk MB to receive posterior fossa radiation therapy (PFRT) or involved field radiation therapy (IFRT) following CSI. Young children (3-7 years) were also randomly assigned to receive standard-dose CSI (SDCSI; 23.4 Gy) or low-dose CSI (LDCSI; 18 Gy). Post hoc molecular classification and mutational analysis contextualized outcomes according to known biologic subgroups (Wingless, Sonic Hedgehog, group 3, and group 4) and genetic biomarkers. Neurocognitive changes and ototoxicity were monitored over time. RESULTS Five hundred forty-nine patients were enrolled on study, of which 464 were eligible and evaluable to compare PFRT versus IFRT and 226 for SDCSI versus LDCSI. The five-year event-free survival (EFS) was 82.5% (95% CI, 77.2 to 87.8) and 80.5% (95% CI, 75.2 to 85.8) for the IFRT and PFRT regimens, respectively, and 71.4% (95% CI, 62.8 to 80) and 82.9% (95% CI, 75.6 to 90.2) for the LDCSI and SDCSI regimens, respectively. IFRT was not inferior to PFRT (hazard ratio, 0.97; 94% upper CI, 1.32). LDCSI was inferior to SDCSI (hazard ratio, 1.67%; 80% upper CI, 2.10). Improved EFS was observed in patients with Sonic Hedgehog MB who were randomly assigned to the IFRT arm (P = .018). Patients with group 4 MB receiving LDCSI exhibited inferior EFS (P = .047). Children receiving SDCSI exhibited greater late declines in IQ (estimate = 5.87; P = .021). CONCLUSION Reducing the radiation boost volume in average-risk MB is safe and does not compromise survival. Reducing CSI dose in young children with average-risk MB results in inferior outcomes, possibly in a subgroup-dependent manner, but is associated with better neurocognitive outcome. Molecularly informed patient selection warrants further exploration for children with MB to be considered for late-effect sparing approaches.
Collapse
Affiliation(s)
- Jeff M Michalski
- Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO
| | - Anna J Janss
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - L Gilbert Vezina
- Division of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC
| | - Kyle S Smith
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN
| | - Catherine A Billups
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN
| | - Peter C Burger
- Department of Neuropathology, Johns Hopkins University, Baltimore, MD
| | - Leanne M Embry
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | | | - Kristina K Hardy
- Division of Neuropsychology, Children's National Medical Center, Washington, DC
| | | | - Johnnie K Bass
- Department of Rehabilitation Services, St Jude's Children's Research Hospital, Memphis, TN
| | - Stephanie M Perkins
- Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO
| | - Thomas E Merchant
- Department of Radiation Oncology, St Jude's Children's Research Hospital, Memphis, TN
| | - Paul D Colte
- Division of Hematology/Oncology/BMT, Primary Children's Hospital, Aurora, CO
| | | | - Timothy N Booth
- Department of Radiology, UT Southwestern/Simmons Cancer Center, Dallas, TX
| | - Joel M Cherlow
- Department of Radiation Oncology, Miller Children's and Women's Hospital Long Beach, Long Beach, CA
| | - Karin M Muraszko
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - Jennifer Hadley
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN
| | - Rahul Kumar
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN
| | - Yuanyuan Han
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN
| | - Nancy J Tarbell
- Department of Radiation Oncology, Massachusetts General Hospital Cancer Center, Boston, MA
| | - Maryam Fouladi
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH
| | - Ian F Pollack
- Department of Neurosurgery, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Roger J Packer
- Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, Washington, DC
| | - Yimei Li
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN
| | - Amar Gajjar
- Department of Oncology, St Jude's Children's Research Hospital, Memphis, TN
| | - Paul A Northcott
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN
| |
Collapse
|
5
|
Liu APY, Wu G, Orr BA, Lin T, Ashford JM, Bass JK, Bowers DC, Hassall T, Fisher PG, Indelicato DJ, Klimo P, Boop F, Conklin H, Onar-Thomas A, Merchant TE, Ellison DW, Gajjar A, Robinson GW. Outcome and molecular analysis of young children with choroid plexus carcinoma treated with non-myeloablative therapy: results from the SJYC07 trial. Neurooncol Adv 2020; 3:vdaa168. [PMID: 33506206 PMCID: PMC7813199 DOI: 10.1093/noajnl/vdaa168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Choroid plexus carcinoma (CPC) is a rare and aggressive tumor of infancy without a clear treatment strategy. This study describes the outcomes of children with CPC treated on the multi-institutional phase 2 SJYC07 trial and reports on the significance of clinical and molecular characteristics. Methods Eligible children <3 years-old with CPC were postoperatively stratified to intermediate-risk (IR) stratum if disease was localized or high-risk (HR) stratum, if metastatic. All received high-dose methotrexate-containing induction chemotherapy. IR-stratum patients received focal irradiation as consolidation whereas HR-stratum patients received additional chemotherapy. Consolidation was followed by oral antiangiogenic maintenance regimen. Survival rates and potential prognostic factors were analyzed. Results Thirteen patients (median age: 1.41 years, range: 0.21-2.93) were enrolled; 5 IR, 8 HR. Gross-total resection or near-total resection was achieved in ten patients and subtotal resection in 3. Seven patients had TP53-mutant tumors, including 4 who were germline carriers. Five patients experienced progression and died of disease; 8 (including 5 HR) are alive without progression. The 5-year progression-free survival (PFS) and overall survival rates were 61.5 ± 13.5% and 68.4 ± 13.1%. Patients with TP53-wild-type tumors had a 5-year PFS of 100% as compared to 28.6 ± 17.1% for TP53-mutant tumors (P = .012). Extent of resection, metastatic status, and use of radiation therapy were not significantly associated with survival. Conclusions Non-myeloablative high-dose methotrexate-containing therapy with maximal surgical resection resulted in long-term PFS in more than half of patients with CPC. TP53-mutational status was the only significant prognostic variable and should form the basis of risk-stratification in future trials.
Collapse
Affiliation(s)
- Anthony P Y Liu
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Gang Wu
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Brent A Orr
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Tong Lin
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jason M Ashford
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Johnnie K Bass
- Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Daniel C Bowers
- Division of Pediatric Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tim Hassall
- Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Paul G Fisher
- Department of Neurology, Stanford University, Palo Alto, California, USA
| | - Daniel J Indelicato
- Department of Radiation Oncology, University of Florida College of Medicine-Jacksonville, Semmes Murphey Clinic, Memphis, Tennessee, USA
| | - Paul Klimo
- Department of Surgery, St. Jude Children's Research Hospital, Semmes Murphey Clinic, Memphis, Tennessee, USA.,Department of Neurosurgery, University of Tennessee Health Science Center, Semmes Murphey Clinic, Memphis, Tennessee, USA.,Le Bonheur Neuroscience Institute, Le Bonheur Children's Hospital, Semmes Murphey Clinic, Memphis, Tennessee, USA.,Semmes Murphey Clinic, Memphis, Tennessee, USA
| | - Frederick Boop
- Department of Surgery, St. Jude Children's Research Hospital, Semmes Murphey Clinic, Memphis, Tennessee, USA.,Department of Neurosurgery, University of Tennessee Health Science Center, Semmes Murphey Clinic, Memphis, Tennessee, USA.,Le Bonheur Neuroscience Institute, Le Bonheur Children's Hospital, Semmes Murphey Clinic, Memphis, Tennessee, USA.,Semmes Murphey Clinic, Memphis, Tennessee, USA
| | - Heather Conklin
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Arzu Onar-Thomas
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Thomas E Merchant
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - David W Ellison
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Amar Gajjar
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Giles W Robinson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| |
Collapse
|
6
|
Abstract
Purpose The purpose of this study was to construct and validate a recorded word recognition test for monolingual Spanish-speaking children utilizing a picture board and a picture-pointing task. Design The Spanish Pediatric Picture Identification Test was developed and validated in this study. Test construction steps included (a) producing new digital recordings of word lists created by Comstock and Martin (1984) using a bilingual Spanish-English female, (b) obtaining list equivalency, (c) creating digitally illustrated pictures representing the word lists, (d) validating the pictures using monolingual Spanish-speaking and bilingual Spanish-English children, and (e) re-establishing list equivalency and obtaining performance-intensity functions using a picture-pointing task with monolingual Spanish-speaking children and bilingual Spanish-English adults. Results Normative data for three Spanish word recognition lists were established. Performance-intensity functions at sensation levels from 0 to 40 dB SL in 8-dB steps were obtained, establishing list equivalency for Lists 1, 2, and 3. Conclusions The Spanish Pediatric Picture Identification Test was developed and validated as a picture-pointing task for word recognition with monolingual Spanish-speaking children. The two validated channel recordings include an English translation for ease of testing by clinicians lacking Spanish language skills. Future validation will be conducted with bilingual Spanish-English children with normal hearing and with hearing loss.
Collapse
Affiliation(s)
- Lisa Lucks Mendel
- School of Communication Sciences and Disorders, The University of Memphis, TN
| | - Monique A. Pousson
- School of Communication Sciences and Disorders, The University of Memphis, TN
| | | | | | - Melanie Morris
- Mobile Audiology Program, Georgia Department of Education, Atlanta
| | | |
Collapse
|
7
|
Bass JK, Liu W, Banerjee P, Brinkman TM, Mulrooney DA, Gajjar A, Pappo AS, Merchant TE, Armstrong GT, Srivastava D, Robison LL, Hudson MM, Krull KR. Association of Hearing Impairment With Neurocognition in Survivors of Childhood Cancer. JAMA Oncol 2020; 6:1363-1371. [PMID: 32729886 PMCID: PMC7393588 DOI: 10.1001/jamaoncol.2020.2822] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/19/2020] [Indexed: 11/14/2022]
Abstract
Importance Despite advancements in cancer therapy and supportive care, childhood cancer survivors remain at risk for chronic morbidities associated with disease and treatment, such as hearing impairment (HI) and neurocognitive deficits. This study, to our knowledge, is the first to objectively measure hearing and neurocognitive function in a large cohort of long-term survivors of childhood cancer stratified by treatment exposures. Objective To assess the association of HI with neurocognitive function and the factors in HI that mediate neurocognitive outcomes in survivors of childhood cancer. Design, Setting, and Participants Data analyzed in this cross-sectional study were collected for the period April 25, 2007, to June 30, 2017, from participants in the St. Jude Lifetime Cohort Study (SJLIFE), an ongoing study that quantifies the long-term health outcomes of survivors of childhood cancer. Participants included those treated at St. Jude Children's Research Hospital (Memphis, Tennessee) for childhood cancer who survived 5 or more years after their original diagnosis and who were eligible for audiologic and neurocognitive testing. Hearing outcomes were coded using the Chang Ototoxicity Grading Scale. Data analysis was performed from March 22, 2019, to March 5, 2020. Main Outcomes and Measures Hearing and neurocognitive function. Survivors were grouped by hearing sensitivity (normal hearing [Chang grade 0], mild HI [Chang grades 1a, 1b, and 2a], or severe HI [Chang grade ≥2b]) and stratified by treatment exposure (platinum-only exposure group [treated with cisplatin and/or carboplatin chemotherapy], cochlear radiotherapy [RT] exposure group [treated with cochlear RT with or without platinum-based chemotherapy], or no exposure group [no platinum-based chemotherapy or cochlear RT]). Multivariable log-binomial models were adjusted for age at diagnosis, time since diagnosis, sex, and relevant treatment exposures. Results A total of 1520 survivors of childhood cancer were analyzed, among whom 814 were male survivors (53.6%), the median (interquartile range [IQR]) age was 29.4 (7.4-64.7) years, and the median (IQR) time since diagnosis was 20.4 (6.1-53.8) years. Prevalence and risk of severe HI among survivors were higher in survivors in the platinum-only (n = 107 [34.9%]; relative risk [RR], 1.68 [95% CI, 1.20-2.37]) or cochlear RT (n = 181 [38.3%]; RR, 2.69 [95% CI, 2.02-3.57) exposure group compared with those in the no exposure group (n = 65 [8.8%]). Severe HI was associated with deficits in verbal reasoning skills (no exposure group RR, 1.11 [95% CI, 0.50-2.43]; platinum-only exposure group RR, 1.93 [95% CI, 1.21-3.08]; cochlear RT exposure group RR, 2.00 [95% CI, 1.46-2.75]), verbal fluency (no exposure group RR, 1.86 [95% CI, 1.19-2.91]; platinum-only exposure group RR, 1.83 [95% CI, 1.24-2.71]; cochlear RT exposure group RR, 1.45 [95% CI, 1.09-1.94]), visuomotor speed (no exposure group RR, 1.87 [95% CI, 1.07-3.25]; platinum-only exposure group RR, 3.10 [95% CI, 1.92-4.99]; cochlear RT exposure group RR, 1.40 [95% CI, 1.11-1.78]), and mathematics skills (no exposure group RR, 1.90 [95% CI, 1.18-3.04]; platinum-only exposure group RR, 1.63 [95% CI, 1.05-2.53]; cochlear RT exposure group RR, 1.58 [95% CI, 1.15-2.18]), compared with survivors with normal hearing or with mild HI. Conclusions and Relevance Results of this study suggest that severe HI in childhood cancer survivors is associated with neurocognitive deficits independent of the neurotoxic treatment received. Early screening and intervention for HI may facilitate the development and maintenance of neurocognitive function and identify individuals at risk for impairment.
Collapse
Affiliation(s)
- Johnnie K. Bass
- Rehabilitation Services, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Wei Liu
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Pia Banerjee
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Tara M. Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Daniel A. Mulrooney
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Amar Gajjar
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Alberto S. Pappo
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Thomas E. Merchant
- Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Gregory T. Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Deokumar Srivastava
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Kevin R. Krull
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| |
Collapse
|
8
|
Owusu JT, Doty SB, Adjaye-Gbewonyo D, Bass JK, Wilcox HC, Gallo JJ, Spira AP. Association of sleep characteristics with suicidal ideation and suicide attempt among adults aged 50 and older with depressive symptoms in low- and middle-income countries. Sleep Health 2019; 6:92-99. [PMID: 31757754 DOI: 10.1016/j.sleh.2019.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/12/2019] [Accepted: 08/26/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Investigate the association of sleep characteristics with suicidal ideation and suicide attempt among middle-aged and older adults with depressive symptoms in five low- and middle-income countries (LMICs). DESIGN Cross-sectional. SETTING China, Ghana, India, Russia, and South Africa. PARTICIPANTS Adults aged ≥50 years with depressive symptoms from the World Health Organization (WHO) Study on Global AGEing and Adult Health (n=2,040). MEASUREMENTS Predictors were self-reported average sleep duration for the past 2 nights (<7 hours (shorter), 7 to <9 hours (reference), ≥9 hours (longer)), sleep quality for the past 2 nights (moderate/good/very good [both nights], poor/very poor [≥1 night]), past-month insomnia symptoms (none/mild, moderate, severe/extreme), and past-day daytime sleepiness. Outcomes were past-year suicidal ideation and suicide attempt. Analyses were adjusted for age, sex, household wealth, marital status, self-rated health, cognitive performance, number of depressive symptoms, and country of residence. RESULTS Participants with poor/very poor sleep quality ≥1 night had greater odds of suicidal ideation (vs. moderate/good/very good sleep quality both nights). Participants with moderate and severe/extreme insomnia symptoms had greater odds of suicidal ideation and suicide attempt (vs. none/mild insomnia symptoms). In moderation analyses, greater insomnia symptoms were associated with higher odds of suicidal ideation among women only and those aged 60-60 years and ≥80 years only. CONCLUSIONS Among middle-aged and older adults with depressive symptoms in LMICs, sleep characteristics are markers of-and potential contributors to-suicidal ideation and suicide attempt, and there was evidence of moderation by age and sex. Interventions aimed at preventing suicide-related outcomes in these populations should consider the role of sleep.
Collapse
Affiliation(s)
- J T Owusu
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - S B Doty
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - J K Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Center for Humanitarian Health, Johns Hopkins University, Baltimore, MD, USA
| | - H C Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - J J Gallo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - A P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
9
|
Abstract
Purpose The purpose of this study was to construct a recorded speech recognition threshold (SRT) test for Spanish-speaking children utilizing a picture board and a picture-pointing task. Design The Spanish Pediatric Speech Recognition Threshold (SPSRT) test was developed and validated in this study. Test construction steps included (a) stimulus selection, (b) assessment of familiarity, (c) digital recording, (d) creation of pictures that accurately depicted the target word from the stimulus set, and (e) validation of the test and recordings. SRTs were obtained from 24 Spanish-speaking children whose 1st language was Spanish. Results Normative data are presented that validate the SPSRT and establish the baseline relationship between the pure-tone average and the SRT obtained with the SPSRT. Results indicated that the SPSRT obtained using this test should be within 2-12 dB of an individual's pure-tone average for Spanish-speaking children with normal hearing and minimal hearing loss. Conclusions The SPSRT was developed and validated as a picture-pointing Spanish SRT test to be used with Spanish-speaking children. The 2-channel recording contains an English translation track, making this test easy to administer and interpret for clinicians without knowledge of Spanish.
Collapse
Affiliation(s)
- Lisa Lucks Mendel
- School of Communication Sciences and Disorders, The University of Memphis, TN
| | - Monique Pousson
- School of Communication Sciences and Disorders, The University of Memphis, TN
| | | | | | | |
Collapse
|
10
|
Olivier TW, Bass JK, Ashford JM, Beaulieu R, Scott SM, Schreiber JE, Palmer S, Mabbott DJ, Swain MA, Bonner M, Boyle R, Chapeiski ML, Evankovich KD, Armstrong CL, Knight SJ, Wu S, Onar-Thomas A, Gajjar A, Conklin HM. Cognitive Implications of Ototoxicity in Pediatric Patients With Embryonal Brain Tumors. J Clin Oncol 2019; 37:1566-1575. [PMID: 31046551 PMCID: PMC6599406 DOI: 10.1200/jco.18.01358] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Sensorineural hearing loss (SNHL) is associated with intellectual and academic declines in children treated for embryonal brain tumors. This study expands upon existing research by examining core neurocognitive processes that may result in reading difficulties in children with treatment-related ototoxicity. PATIENTS AND METHODS Prospectively gathered, serial, neuropsychological and audiology data for 260 children and young adults age 3 to 21 years (mean, 9.15 years) enrolled in a multisite research and treatment protocol, which included surgery, risk-adapted craniospinal irradiation (average risk, n = 186; high risk, n = 74), and chemotherapy, were analyzed using linear mixed models. Participants were assessed at baseline and up to 5 years after diagnosis and grouped according to degree of SNHL. Included were 196 children with intact hearing or mild to moderate SNHL (Chang grade 0, 1a, 1b, or 2a) and 64 children with severe SNHL (Chang grade 2b or greater). Performance on eight neurocognitive variables targeting reading outcomes (eg, phonemics, fluency, comprehension) and contributory cognitive processes (eg, working memory, processing speed) was analyzed. RESULTS Participants with severe SNHL performed significantly worse on all variables compared with children with normal or mild to moderate SNHL (P ≤ .05), except for tasks assessing awareness of sounds and working memory. Controlling for age at diagnosis and risk-adapted craniospinal irradiation dose, performance on the following four variables remained significantly lower for children with severe SNHL: phonemic skills, phonetic decoding, reading comprehension, and speed of information processing (P ≤ .05). CONCLUSION Children with severe SNHL exhibit greater reading difficulties over time. Specifically, they seem to struggle most with phonological skills and processing speed, which affect higher level skills such as reading comprehension.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Michelle A Swain
- 4 Royal Children's Hospital Brisbane, Herston, Queensland, Australia
| | | | - Robyn Boyle
- 6 Sydney Children's Hospital, Randwick, New South Wales, Australia
| | | | | | | | - Sarah J Knight
- 8 Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Shengjie Wu
- 1 St Jude Children's Research Hospital, Memphis, TN
| | | | - Amar Gajjar
- 1 St Jude Children's Research Hospital, Memphis, TN
| | | |
Collapse
|
11
|
Tol WA, Murray SM, Lund C, Bolton P, Murray LK, Davies T, Haushofer J, Orkin K, Witte M, Salama L, Patel V, Thornicroft G, Bass JK. Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review. BMC Womens Health 2019; 19:34. [PMID: 30764813 PMCID: PMC6376658 DOI: 10.1186/s12905-019-0728-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/25/2019] [Indexed: 01/21/2023]
Abstract
Background Epidemiological research suggests an interrelationship between mental health problems and the (re)occurrence of intimate partner violence (IPV). However, little is known about the impact of mental health treatments on IPV victimization or perpetration, especially in low- and middle-income countries (LMIC). Methods We conducted a systematic review to identify prospective, controlled studies of mental health treatments in LMIC. We defined ‘mental health treatment’ as an intervention for individuals experiencing mental ill health (including substance misuse) including a substantial psychosocial or pharmacological component. Studies had to measure a mental health and IPV outcome. We searched across multi-disciplinary databases using a structured search strategy. Screening of title/abstracts and full-text eligibility assessments were conducted by two researchers independently, data were extracted using a piloted spreadsheet, and a narrative synthesis was generated. Results We identified seven studies reported in 11 papers conducted in five middle-income countries. With the exception of blinding, studies overall showed acceptable levels of risk of bias. Four of the seven studies focused on dedicated mental health treatments in various populations, including: common mental disorders in earthquake survivors; depression in primary care; alcohol misuse in men; and alcohol misuse in female adult sex workers. The dedicated mental health treatments targeting depression or alcohol misuse consistently reduced levels of these outcomes. The two studies targeting depression also reduced short-term IPV, but no IPV benefits were identified in the two alcohol-focused studies. The other three studies evaluated integrated interventions, in which a focus on substance misuse was part of efforts to reduce HIV/AIDS and violence against particularly vulnerable women. In contrast to the dedicated mental health interventions, the integrated interventions did not consistently reduce mental ill health or alcohol misuse compared to control conditions. Conclusions Too few studies have been conducted to judge whether mental health treatments may provide a beneficial strategy to prevent or reduce IPV in LMIC. Key future research questions include: whether promising initial evidence on the effects of depression interventions on reducing IPV hold more broadly, the required intensity of mental health components in integrated interventions, and the identification of mechanisms of IPV that are amenable to mental health intervention. Electronic supplementary material The online version of this article (10.1186/s12905-019-0728-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- W A Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, HH795, Baltimore, MD, 21205, USA. .,Peter C. Alderman Program for Global Mental Health, HealthRight International, New York, USA.
| | - S M Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, HH795, Baltimore, MD, 21205, USA
| | - C Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - P Bolton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, HH795, Baltimore, MD, 21205, USA.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - L K Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, HH795, Baltimore, MD, 21205, USA
| | - T Davies
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - J Haushofer
- Department of Psychology and Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ, USA.,National Bureau of Economic Research, Cambridge, MA, USA.,Busara Center for Behavioral Economics, Nairobi, Kenya
| | - K Orkin
- Blavatnik School of Government and Centre for the Study of African Economies, University of Oxford, Oxford, UK.,Merton College, University of Oxford, Oxford, UK
| | - M Witte
- Department of Economics and Centre for the Study of African Economies, University of Oxford, Oxford, UK
| | - L Salama
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, HH795, Baltimore, MD, 21205, USA
| | - V Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA.,Department of Global Health and Population, Harvard Chan School of Public Health, Boston, USA
| | - G Thornicroft
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J K Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, HH795, Baltimore, MD, 21205, USA
| |
Collapse
|
12
|
Liu APY, Hastings C, Wu S, Bass JK, Heitzer AM, Ashford J, Vestal R, Hoehn ME, Ghazwani Y, Acharya S, Conklin HM, Boop F, Merchant TE, Gajjar A, Qaddoumi I. Treatment burden and long-term health deficits of patients with low-grade gliomas or glioneuronal tumors diagnosed during the first year of life. Cancer 2019; 125:1163-1175. [PMID: 30620400 DOI: 10.1002/cncr.31918] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 10/16/2018] [Accepted: 11/01/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Low-grade gliomas (LGGs) and low-grade glioneuronal tumors (LGGNTs) diagnosed during the first year of life carry unique clinical characteristics and challenges in management. However, data on the treatment burden, outcomes, and morbidities are lacking. METHODS A retrospective study of LGGs and LGGNTs diagnosed in patients younger than 12 months at St. Jude Children's Research Hospital (1986-2015) was conducted. RESULTS For the 51 patients (including 31 males), the mean age at diagnosis was 6.47 months (range, 0.17-11.76 months), and the mean follow-up period was 11.8 years (range, 0.21-29.19 years). Tumor locations were hypothalamic/optic pathway (61%), hemispheric (12%), brainstem (12%), cerebellar (8%), and spinal (8%). There were 41 patients with histological diagnoses: 28 had World Health Organization grade 1 tumors, 6 had grade 2 tumors, and 7 had an LGG/LGGNT not definitively graded. Forty-one patients required an active intervention at diagnosis. Throughout their treatment course, 41 patients eventually underwent tumor-directed surgeries (median, 2 surgeries; range, 1-6), 39 received chemotherapy (median, 2 regimens; range, 1-13), and 21 received radiotherapy. Forty patients experienced disease progression (median, 2 progressions; range, 1-18). Ten patients died of progression (n = 5), malignant transformation (n = 2), a second cancer (n = 2), or a shunt infection (n = 1). The 10-year overall survival, progression-free survival, and radiation-free survival rates were 85% ± 5.3%, 16.9% ± 5.3%, and 51.2% ± 7.5%, respectively. Forty-nine patients experienced health deficits (eg, endocrinopathies, obesity, seizures, visual/hearing impairments, neurocognitive impairments, and cerebrovascular disease). Predictors of progression and toxicities were defined. CONCLUSIONS Infantile LGG/LGGNT is a chronic, progressive disease universally associated with long-term morbidities and requires multidisciplinary intervention.
Collapse
Affiliation(s)
- Anthony P Y Liu
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Camden Hastings
- Pediatric Oncology Education Program, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Shengjie Wu
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Johnnie K Bass
- St. Jude Children's Research Hospital, Rehabilitation Services, Memphis, Tennessee
| | - Andrew M Heitzer
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Jason Ashford
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Robert Vestal
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Mary E Hoehn
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee.,Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Yahya Ghazwani
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Sahaja Acharya
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Heather M Conklin
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Frederick Boop
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee.,Le Bonheur Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, Tennessee.,Semmes Murphey Clinic, Memphis, Tennessee
| | - Thomas E Merchant
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Amar Gajjar
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| |
Collapse
|
13
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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.
| |
Collapse
|
14
|
Bass JK, Huang J, Hua CH, Bhagat SP, Mendel LL, Onar-Thomas A, Indelicato DJ, Merchant TE. Auditory Outcomes in Patients Who Received Proton Radiotherapy for Craniopharyngioma. Am J Audiol 2018; 27:306-315. [PMID: 30073327 DOI: 10.1044/2018_aja-18-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/18/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Compared to photon-based radiotherapy, protons deliver less radiation to healthy tissue resulting in the potential reduction of late complications such as sensorineural hearing loss (SNHL). We report early auditory outcomes in children treated with proton radiotherapy (PRT) for craniopharyngioma. METHOD Conventional frequency (CF = 0.25-8.0 kHz) audiometry, extended high-frequency (EHF = 9.0-16.0 kHz) audiometry, distortion product otoacoustic emission (DPOAE) testing, and speech-in-noise (SIN) assessments were prospectively and longitudinally conducted on 74 children with a median of 2 post-PRT evaluations (range, 1-5) per patient. The median age at PRT initiation was 10 years, and median follow-up time was 2 years. Ototoxicity was classified using the Chang Ototoxicity Grading Scale (Chang & Chinosornvatana, 2010) and the American Speech-Language-Hearing Association (ASHA) criteria (ASHA, 1994). Comparisons were made between baseline and most recent DPOAE levels, with evidence of ototoxicity based on criterion reductions of ≥ 6 dB. The critical difference values for comparing SIN scores between two conditions (i.e., pre- and post-PRT) were used to determine a significant change between test scores. RESULTS At last evaluation, no patients had SNHL in the CF range, and 2 patients had SNHL (Chang Grade 1a) in the EHF range. Based on the ASHA criteria, a decrease in hearing was observed in 0 patients in the CF range alone, in 9 patients in the EHF range alone, and in 15 patients in both the CF and EHF ranges. DPOAE levels decreased at a faster rate at higher versus lower frequencies. For 41 evaluable patients, SIN perception did not decline over time (p = .6463). CONCLUSION At a median follow-up time of 2 years post-PRT, normal hearing was maintained within the CF range. However, subclinical decreases in hearing were observed, particularly in the EHF range and in the DPOAE level; thus, long-term follow-up is recommended to monitor for potential auditory late effects from PRT.
Collapse
Affiliation(s)
- Johnnie K. Bass
- Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN
| | - Jie Huang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
| | - Chia-Ho Hua
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Shaum P. Bhagat
- Department of Communication Disorders and Sciences, San Jose State University, CA
| | - Lisa Lucks Mendel
- School of Communication Sciences and Disorders, University of Memphis, TN
| | - Arzu Onar-Thomas
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
| | | | - Thomas E. Merchant
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN
| |
Collapse
|
15
|
Liu A, Hastings C, Wu S, Bass JK, Heitzer A, Ashford J, Vestal R, Hoehn M, Chiang J, Ghazwani Y, Acharya S, Conklin H, Boop F, Gajjar A, Qaddoumi I. LGG-22. TREATMENT OUTCOME AND LONG-TERM HEALTH DEFICITS OF PATIENTS WITH LOW-GRADE GLIOMA DIAGNOSED DURING THE FIRST YEAR OF LIFE. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Anthony Liu
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Camden Hastings
- Pediatric Oncology Education Program, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Shengjie Wu
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - Johnnie K Bass
- Rehabilitation Services, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Andrew Heitzer
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Jason Ashford
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Robert Vestal
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Mary Hoehn
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jason Chiang
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Yahya Ghazwani
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Sahaja Acharya
- Department of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Heather Conklin
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Frederick Boop
- Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
- Le Bonheur Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN, USA
- Semmes Murphey Clinic, Memphis, TN, USA
| | - Amar Gajjar
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| |
Collapse
|
16
|
Owusu JT, Doty SB, Bass JK, Wilcox HC, Gallo JJ, Spira AP. 0987 Sleep Characteristics, Suicidal Ideation, and Attempts among Adults Aged 50+ with Depressive Symptoms in Five Middle-Income Countries. Sleep 2018. [DOI: 10.1093/sleep/zsy061.986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J T Owusu
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - S B Doty
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - J K Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Center for Humanitarian Health, Johns Hopkins University, Baltimore, MD
| | - H C Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - J J Gallo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - A P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| |
Collapse
|
17
|
Murray SM, Augustinavicius J, Kaysen D, Rao D, Murray LK, Wachter K, Annan J, Falb K, Bolton P, Bass JK. The impact of Cognitive Processing Therapy on stigma among survivors of sexual violence in eastern Democratic Republic of Congo: results from a cluster randomized controlled trial. Confl Health 2018; 12:1. [PMID: 29449879 PMCID: PMC5808396 DOI: 10.1186/s13031-018-0142-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 01/12/2018] [Indexed: 12/02/2022] Open
Abstract
Background Sexual violence is associated with a multitude of poor physical, emotional, and social outcomes. Despite reports of stigma by sexual violence survivors, limited evidence exists on effective strategies to reduce stigma, particularly in conflict-affected settings. We sought to assess the effect of group Cognitive Processing Therapy (CPT) on stigma and the extent to which stigma might moderate the effectiveness of CPT in treating mental health problems among survivors of sexual violence in the Democratic Republic of Congo. Methods Data were drawn from 405 adult female survivors of sexual violence reporting mental distress and poor functioning in North and South Kivu. Women were recruited through organizations providing psychosocial support and then cluster randomized to group CPT or individual support. Women were assessed at baseline, the end of treatment, and again six months later. Assessors were masked to women’s treatment assignment. Linear mixed-effect regression models were used to estimate (1) the effect of CPT on feelings of perceived and internalized (felt) stigma, and (2) whether felt stigma and discrimination (enacted stigma) moderated the effects of CPT on combined depression and anxiety symptoms, posttraumatic stress, and functional impairment. Results Participants receiving CPT experienced moderate reductions in felt stigma relative to those in individual support (Cohen’s D = 0.44, p = value = 0.02) following the end of treatment, though this difference was no longer significant six-months later (Cohen’s D = 0.45, p = value = 0.12). Neither felt nor enacted stigma significantly moderated the effect of CPT on mental health symptoms or functional impairment. Conclusions Group cognitive-behavioral based therapies may be an effective stigma reduction tool for survivors of sexual violence. Experiences and perceptions of stigma did not hinder therapeutic effects of group psychotherapy on survivors’ mental health. Trial registration ClinicalTrials.gov NCT01385163. Electronic supplementary material The online version of this article (10.1186/s13031-018-0142-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- S M Murray
- 1Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N Broadway Street, Baltimore, MD 21205 USA
| | - J Augustinavicius
- 1Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N Broadway Street, Baltimore, MD 21205 USA
| | - D Kaysen
- 2Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
| | - D Rao
- 2Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA.,3Department of Global Health, University of Washington, Seattle, WA USA
| | - L K Murray
- 1Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N Broadway Street, Baltimore, MD 21205 USA
| | - K Wachter
- 4University of Texas, School of Social Work, Austin, TX USA
| | - J Annan
- 5Research, Evaluation and Learning Unit, International Rescue Committee, New York, NY USA.,6Harris School of Public Policy, University of Chicago, Chicago, USA
| | - K Falb
- 5Research, Evaluation and Learning Unit, International Rescue Committee, New York, NY USA
| | - P Bolton
- 1Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N Broadway Street, Baltimore, MD 21205 USA.,7Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD USA
| | - J K Bass
- 1Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N Broadway Street, Baltimore, MD 21205 USA
| |
Collapse
|
18
|
Ghazwani Y, Qaddoumi I, Bass JK, Wu S, Chiang J, Boop F, Gajjar A, Sadighi Z. Profound hearing loss following surgery in pediatric patients with posterior fossa low-grade glioma. Neurooncol Pract 2017; 5:96-103. [PMID: 29770223 DOI: 10.1093/nop/npx025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Hearing loss may occur in patients with posterior fossa low-grade glioma who undergo surgery. Methods We retrospectively reviewed 217 patients with posterior fossa low-grade glioma, including 115 for whom results of hearing tests performed after surgery and before chemotherapy or radiation therapy were available. We explored the association of UHL with age at diagnosis, sex, race, tumor location, extent of resection, posterior fossa syndrome, ventriculoperitoneal shunt placement, and histology. Results Of the 115 patients, 15 (13.0%: 11 male, 6 black, 8 white, 1 multiracial; median age 7 years [range, 1.3-17.2 years]) had profound UHL after surgery alone or before receiving ototoxic therapy. Median age at tumor diagnosis was 6.8 years (range, 0.7-14.1 years), and median age at surgery was 6.8 years (range, 0.7-14.1 years). Patients with UHL had pathology characteristic of pilocytic astrocytoma (n = 10), ganglioglioma (n = 4), or low-grade astrocytoma (n = 1). Of these 15 patients, 4 underwent biopsy, 1 underwent gross total resection, 1 underwent near-total resection, and 9 underwent subtotal resection. UHL was more frequent in black patients than in white patients (OR 7.3, P = .007) and less frequent in patients who underwent gross total resection or near-total resection than in those who underwent subtotal resection (OR 0.11, P = .02). Conclusions Children undergoing surgery for posterior fossa low-grade glioma are at risk for UHL, which may be related to race or extent of resection. These patients should receive postoperative audiologic testing, as earlier intervention may improve outcomes.
Collapse
Affiliation(s)
- Yahya Ghazwani
- Department of Oncology, St. Jude Children's Research Hospital, USA
| | - Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children's Research Hospital, USA
| | - Johnnie K Bass
- Rehabilitation Services, St. Jude Children's Research Hospital, USA
| | - Shengjie Wu
- Department of Biostatistics, St. Jude Children's Research Hospital, USA
| | - Jason Chiang
- Department of Pathology, St Jude Children's Research Hospital, USA
| | - Frederick Boop
- Department of Neurosurgery, University of Tennessee Health Science Center, USA.,Le Bonheur Neuroscience Institute, Le Bonheur Children's Hospital, USA.,Semmes Murphey Neurologic and Spine Institute, USA.,Division of Neurosurgery, St Jude Children's Research Hospital, USA
| | - Amar Gajjar
- Department of Oncology, St. Jude Children's Research Hospital, USA
| | - Zsila Sadighi
- Department of Pediatric Medicine, Division of Neurology, St. Jude Children's Research Hospital, USA
| |
Collapse
|
19
|
Haroz EE, Ritchey M, Bass JK, Kohrt BA, Augustinavicius J, Michalopoulos L, Burkey MD, Bolton P. How is depression experienced around the world? A systematic review of qualitative literature. Soc Sci Med 2017; 183:151-162. [PMID: 28069271 PMCID: PMC5488686 DOI: 10.1016/j.socscimed.2016.12.030] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 12/16/2016] [Accepted: 12/20/2016] [Indexed: 11/18/2022]
Abstract
To date global research on depression has used assessment tools based on research and clinical experience drawn from Western populations (i.e., in North American, European and Australian). There may be features of depression in non-Western populations which are not captured in current diagnostic criteria or measurement tools, as well as criteria for depression that are not relevant in other regions. We investigated this possibility through a systematic review of qualitative studies of depression worldwide. Nine online databases were searched for records that used qualitative methods to study depression. Initial searches were conducted between August 2012 and December 2012; an updated search was repeated in June of 2015 to include relevant literature published between December 30, 2012 and May 30, 2015. No date limits were set for inclusion of articles. A total of 16,130 records were identified and 138 met full inclusion criteria. Included studies were published between 1976 and 2015. These 138 studies represented data on 170 different study populations (some reported on multiple samples) and 77 different nationalities/ethnicities. Variation in results by geographical region, gender, and study context were examined to determine the consistency of descriptions across populations. Fisher's exact tests were used to compare frequencies of features across region, gender and context. Seven of the 15 features with the highest relative frequency form part of the DSM-5 diagnosis of Major Depressive Disorder (MDD). However, many of the other features with relatively high frequencies across the studies are associated features in the DSM, but are not prioritized as diagnostic criteria and therefore not included in standard instruments. The DSM-5 diagnostic criteria of problems with concentration and psychomotor agitation or slowing were infrequently mentioned. This research suggests that the DSM model and standard instruments currently based on the DSM may not adequately reflect the experience of depression at the worldwide or regional levels.
Collapse
Affiliation(s)
- E E Haroz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States.
| | - M Ritchey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD 21205, United States
| | - J K Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - B A Kohrt
- Duke University, Duke Global Health Institute & Department of Psychiatry and Behavioral Sciences, Durham, NC 27710, United States
| | - J Augustinavicius
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - L Michalopoulos
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, United States
| | - M D Burkey
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - P Bolton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, United States
| |
Collapse
|
20
|
Hudson MM, Ehrhardt MJ, Bhakta N, Baassiri M, Eissa H, Chemaitilly W, Green DM, Mulrooney DA, Armstrong GT, Brinkman TM, Klosky JL, Krull KR, Sabin ND, Wilson CL, Huang IC, Bass JK, Hale K, Kaste S, Khan RB, Srivastava DK, Yasui Y, Joshi VM, Srinivasan S, Stokes D, Hoehn ME, Wilson M, Ness KK, Robison LL. Approach for Classification and Severity Grading of Long-term and Late-Onset Health Events among Childhood Cancer Survivors in the St. Jude Lifetime Cohort. Cancer Epidemiol Biomarkers Prev 2016; 26:666-674. [PMID: 28035022 DOI: 10.1158/1055-9965.epi-16-0812] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 11/28/2016] [Accepted: 12/15/2016] [Indexed: 01/12/2023] Open
Abstract
Characterization of toxicity associated with cancer and its treatment is essential to quantify risk, inform optimization of therapeutic approaches for newly diagnosed patients, and guide health surveillance recommendations for long-term survivors. The NCI Common Terminology Criteria for Adverse Events (CTCAE) provides a common rubric for grading severity of adverse outcomes in cancer patients that is widely used in clinical trials. The CTCAE has also been used to assess late cancer treatment-related morbidity but is not fully representative of the spectrum of events experienced by pediatric and aging adult survivors of childhood cancer. Also, CTCAE characterization does not routinely integrate detailed patient-reported and medical outcomes data available from clinically assessed cohorts. To address these deficiencies, we standardized the severity grading of long-term and late-onset health events applicable to childhood cancer survivors across their lifespan by modifying the existing CTCAE v4.03 criteria and aligning grading rubrics from other sources for chronic conditions not included or optimally addressed in the CTCAE v4.03. This article describes the methods of late toxicity assessment used in the St. Jude Lifetime Cohort Study, a clinically assessed cohort in which data from multiple diagnostic modalities and patient-reported outcomes are ascertained. Cancer Epidemiol Biomarkers Prev; 26(5); 666-74. ©2016 AACR.
Collapse
Affiliation(s)
- Melissa M Hudson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee. .,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Matthew J Ehrhardt
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Nickhill Bhakta
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Global Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Malek Baassiri
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Hesham Eissa
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Wassim Chemaitilly
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Daniel M Green
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Daniel A Mulrooney
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Gregory T Armstrong
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - James L Klosky
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Noah D Sabin
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Carmen L Wilson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Johnnie K Bass
- Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Karen Hale
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Sue Kaste
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Raja B Khan
- Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Deo Kumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Vijaya M Joshi
- University of Tennessee College of Medicine, Memphis, Tennessee
| | | | - Dennis Stokes
- University of Tennessee College of Medicine, Memphis, Tennessee
| | | | - Matthew Wilson
- University of Tennessee College of Medicine, Memphis, Tennessee
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| |
Collapse
|
21
|
Murray SM, Familiar I, Nakasujja N, Winch PJ, Gallo JJ, Opoka R, Caesar JO, Boivin MJ, Bass JK. Caregiver mental health and HIV-infected child wellness: perspectives from Ugandan caregivers. AIDS Care 2016; 29:793-799. [PMID: 27951734 DOI: 10.1080/09540121.2016.1263722] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Prior studies indicate a substantial link between maternal depression and early child health but give limited consideration to the direction of this relationship or the context in which it occurs. We sought to create a contextually informed conceptual framework of this relationship through semi-structured interviews with women that had lived experience of caring for an HIV-infected child while coping with depression and anxiety symptoms. Caregivers explained their role in raising healthy children as complex and complicated by poverty, stigma, and isolation. Caregivers discussed the effects of their own mental health on child well-being as primarily emotional and behavioral, and explained how looking after a child could bring distress, particularly when unable to provide desired care for sick children. Our findings suggest the need for investigation of the reciprocal effects of child sickness on caregiver wellness and for integrated programs that holistically address the needs of HIV-affected families.
Collapse
Affiliation(s)
- S M Murray
- a Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - I Familiar
- b Department of Psychiatry , Michigan State University , East Lansing , MI , USA
| | - N Nakasujja
- c Department of Psychiatry , Makerere University , Kampala , Uganda
| | - P J Winch
- d Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - J J Gallo
- a Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - R Opoka
- e Department of Pediatrics and Child Health , Makerere University , Kampala , Uganda
| | - J O Caesar
- f Global Health Uganda , Kampala , Uganda
| | - M J Boivin
- b Department of Psychiatry , Michigan State University , East Lansing , MI , USA
| | - J K Bass
- a Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| |
Collapse
|
22
|
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] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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.
Collapse
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
| | - Satkiran S. Grewal
- Pediatric Hematology-Oncology, Baystate Medical Center, Springfield, MA,Correspondence to: Satkiran S. Grewal, MD. M.Sc., Pediatric Hematology-Oncology, Baystate Medical Center, 376 Birnie Avenue, Springfield, MA 01199; telephone: 413-794-5214;
| |
Collapse
|
23
|
Bass JK, Hua CH, Huang J, Onar-Thomas A, Ness KK, Jones S, White S, Bhagat SP, Chang KW, Merchant TE. Hearing Loss in Patients Who Received Cranial Radiation Therapy for Childhood Cancer. J Clin Oncol 2016; 34:1248-55. [PMID: 26811531 DOI: 10.1200/jco.2015.63.6738] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Patients treated with cranial radiation therapy (RT) are at risk for sensorineural hearing loss (SNHL). Although SNHL is often characterized as a delayed consequence of anticancer therapy, longitudinal reports of SNHL in childhood cancer survivors treated with contemporary RT are limited. We report the incidence, onset, severity, and long-term trajectory of SNHL among children receiving RT. Potential risk factors for SNHL were also identified. PATIENTS AND METHODS Serial audiologic testing was conducted on 235 pediatric patients who were treated with conformal or intensity-modulated RT as part of an institutional phase II trial for localized primary brain tumors, including craniopharyngioma, ependymoma, and juvenile pilocytic astrocytoma. All but one patient had measurable cochlear radiation dose (CRD) greater than 0 Gy. The median follow-up from RT initiation to latest audiogram was 9 years with a median of 11 post-RT audiograms per patient. Audiograms were classified by the Chang Ototoxicity Grading Scale. Progression was defined by an increase in Chang grade from SNHL onset to the most recent evaluation. RESULTS At last evaluation, SNHL was prevalent in 14% of patients: 2.1% had mild and 11.9% had significant SNHL requiring hearing aids. Median time from RT to SNHL onset was 3.6 years (range, 0.4 to 13.2 years). Among 29 patients with follow-up evaluations after SNHL onset, 65.5% experienced continued decline in hearing sensitivity in either ear and 34.5% had no change. Younger age at RT initiation (hazard ratio [HR], 2.32; 95% CI, 1.21 to 4.46), higher CRD (HR, 1.07; 95% CI, 1.03 to 1.11), and cerebrospinal fluid shunting (HR, 2.02; 95% CI, 1.07 to 3.78) were associated with SNHL. CONCLUSION SNHL is a late effect of RT that likely worsens over time. Long-term audiologic follow-up for a minimum of 10 years post-RT is recommended.
Collapse
Affiliation(s)
- Johnnie K Bass
- Johnnie K. Bass, Chia-Ho Hua, Jie Huang, Arzu Onar-Thomas, Kirsten K. Ness, Skye Jones, Stephanie White, Shaum P. Bhagat, and Thomas E. Merchant, St Jude Children's Research Hospital; Johnnie K. Bass and Shaum P. Bhagat, University of Memphis, Memphis TN; and Kay W. Chang, Stanford University, Stanford, CA.
| | - Chia-Ho Hua
- Johnnie K. Bass, Chia-Ho Hua, Jie Huang, Arzu Onar-Thomas, Kirsten K. Ness, Skye Jones, Stephanie White, Shaum P. Bhagat, and Thomas E. Merchant, St Jude Children's Research Hospital; Johnnie K. Bass and Shaum P. Bhagat, University of Memphis, Memphis TN; and Kay W. Chang, Stanford University, Stanford, CA
| | - Jie Huang
- Johnnie K. Bass, Chia-Ho Hua, Jie Huang, Arzu Onar-Thomas, Kirsten K. Ness, Skye Jones, Stephanie White, Shaum P. Bhagat, and Thomas E. Merchant, St Jude Children's Research Hospital; Johnnie K. Bass and Shaum P. Bhagat, University of Memphis, Memphis TN; and Kay W. Chang, Stanford University, Stanford, CA
| | - Arzu Onar-Thomas
- Johnnie K. Bass, Chia-Ho Hua, Jie Huang, Arzu Onar-Thomas, Kirsten K. Ness, Skye Jones, Stephanie White, Shaum P. Bhagat, and Thomas E. Merchant, St Jude Children's Research Hospital; Johnnie K. Bass and Shaum P. Bhagat, University of Memphis, Memphis TN; and Kay W. Chang, Stanford University, Stanford, CA
| | - Kirsten K Ness
- Johnnie K. Bass, Chia-Ho Hua, Jie Huang, Arzu Onar-Thomas, Kirsten K. Ness, Skye Jones, Stephanie White, Shaum P. Bhagat, and Thomas E. Merchant, St Jude Children's Research Hospital; Johnnie K. Bass and Shaum P. Bhagat, University of Memphis, Memphis TN; and Kay W. Chang, Stanford University, Stanford, CA
| | - Skye Jones
- Johnnie K. Bass, Chia-Ho Hua, Jie Huang, Arzu Onar-Thomas, Kirsten K. Ness, Skye Jones, Stephanie White, Shaum P. Bhagat, and Thomas E. Merchant, St Jude Children's Research Hospital; Johnnie K. Bass and Shaum P. Bhagat, University of Memphis, Memphis TN; and Kay W. Chang, Stanford University, Stanford, CA
| | - Stephanie White
- Johnnie K. Bass, Chia-Ho Hua, Jie Huang, Arzu Onar-Thomas, Kirsten K. Ness, Skye Jones, Stephanie White, Shaum P. Bhagat, and Thomas E. Merchant, St Jude Children's Research Hospital; Johnnie K. Bass and Shaum P. Bhagat, University of Memphis, Memphis TN; and Kay W. Chang, Stanford University, Stanford, CA
| | - Shaum P Bhagat
- Johnnie K. Bass, Chia-Ho Hua, Jie Huang, Arzu Onar-Thomas, Kirsten K. Ness, Skye Jones, Stephanie White, Shaum P. Bhagat, and Thomas E. Merchant, St Jude Children's Research Hospital; Johnnie K. Bass and Shaum P. Bhagat, University of Memphis, Memphis TN; and Kay W. Chang, Stanford University, Stanford, CA
| | - Kay W Chang
- Johnnie K. Bass, Chia-Ho Hua, Jie Huang, Arzu Onar-Thomas, Kirsten K. Ness, Skye Jones, Stephanie White, Shaum P. Bhagat, and Thomas E. Merchant, St Jude Children's Research Hospital; Johnnie K. Bass and Shaum P. Bhagat, University of Memphis, Memphis TN; and Kay W. Chang, Stanford University, Stanford, CA
| | - Thomas E Merchant
- Johnnie K. Bass, Chia-Ho Hua, Jie Huang, Arzu Onar-Thomas, Kirsten K. Ness, Skye Jones, Stephanie White, Shaum P. Bhagat, and Thomas E. Merchant, St Jude Children's Research Hospital; Johnnie K. Bass and Shaum P. Bhagat, University of Memphis, Memphis TN; and Kay W. Chang, Stanford University, Stanford, CA
| |
Collapse
|
24
|
Magidson JF, Lejuez CW, Kamal T, Blevins EJ, Murray LK, Bass JK, Bolton P, Pagoto S. Adaptation of community health worker-delivered behavioral activation for torture survivors in Kurdistan, Iraq. Glob Ment Health (Camb) 2015; 2:e24. [PMID: 27478619 PMCID: PMC4962865 DOI: 10.1017/gmh.2015.22] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Growing evidence supports the use of Western therapies for the treatment of depression, trauma, and stress delivered by community health workers (CHWs) in conflict-affected, resource-limited countries. A recent randomized controlled trial (Bolton et al. 2014a) supported the efficacy of two CHW-delivered interventions, cognitive processing therapy (CPT) and brief behavioral activation treatment for depression (BATD), for reducing depressive symptoms and functional impairment among torture survivors in the Kurdish region of Iraq. METHODS This study describes the adaptation of the CHW-delivered BATD approach delivered in this trial (Bolton et al.2014a), informed by the Assessment-Decision-Administration-Production-Topical experts-Integration-Training-Testing (ADAPT-ITT) framework for intervention adaptation (Wingood & DiClemente, 2008). Cultural modifications, adaptations for low-literacy, and tailored training and supervision for non-specialist CHWs are presented, along with two clinical case examples to illustrate delivery of the adapted intervention in this setting. RESULTS Eleven CHWs, a study psychiatrist, and the CHW clinical supervisor were trained in BATD. The adaptation process followed the ADAPT-ITT framework and was iterative with significant input from the on-site supervisor and CHWs. Modifications were made to fit Kurdish culture, including culturally relevant analogies, use of stickers for behavior monitoring, cultural modifications to behavioral contracts, and including telephone-delivered sessions to enhance feasibility. CONCLUSIONS BATD was delivered by CHWs in a resource-poor, conflict-affected area in Kurdistan, Iraq, with some important modifications, including low-literacy adaptations, increased cultural relevancy of clinical materials, and tailored training and supervision for CHWs. Barriers to implementation, lessons learned, and recommendations for future efforts to adapt behavioral therapies for resource-limited, conflict-affected areas are discussed.
Collapse
Affiliation(s)
- J F Magidson
- Department of Psychiatry, Massachusetts General Hospital (MGH)/Harvard Medical School, Boston, MA, USA
| | - C W Lejuez
- Department of Psychology, Center for Addictions, Personality, and Emotion Research (CAPER), University of Maryland, College Park, MD, USA
| | - T Kamal
- Fine Arts Institute, University of Sulaimani, Kurdistan Region, Iraq
| | - E J Blevins
- Department of Psychology, Center for Addictions, Personality, and Emotion Research (CAPER), University of Maryland, College Park, MD, USA
| | - L K Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - J K Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - P Bolton
- Center for Refugee and Disaster Response and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - S Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| |
Collapse
|
25
|
Brinkman TM, Bass JK, Li Z, Ness KK, Gajjar A, Pappo AS, Armstrong GT, Merchant TE, Srivastava DK, Robison LL, Hudson MM, Gurney JG. Treatment-induced hearing loss and adult social outcomes in survivors of childhood CNS and non-CNS solid tumors: Results from the St. Jude Lifetime Cohort Study. Cancer 2015; 121:4053-61. [PMID: 26287566 PMCID: PMC4635051 DOI: 10.1002/cncr.29604] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/07/2015] [Accepted: 07/08/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND Survivors of childhood cancer who are treated with platinum-based chemotherapy and/or cranial radiation are at risk of treatment-induced hearing loss. However, the effects of such hearing loss on adult social attainment have not been well elucidated. METHODS Adult survivors of pediatric central nervous system (CNS) solid tumors (180 survivors) and non-CNS solid tumors (226 survivors) who were treated with potentially ototoxic cancer therapy completed audiologic evaluations and questionnaires assessing their perception of social functioning and social attainment (ie, independent living, marriage, and employment). Audiograms were graded with the Chang ototoxicity grading scale. Analyses were stratified by tumor type (ie, CNS vs non-CNS). Multivariable logistic regression models were conducted with adjustment for age; sex; chronic health conditions; and, for the CNS group, IQ. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were reported. RESULTS Serious hearing loss (that requiring a hearing aid or deafness) was detected in 36% of survivors of CNS tumors and 39% of survivors of non-CNS tumors. Serious hearing loss was associated with an increased risk of perceived negative impact in ≥1 areas of social functioning (survivors of non-CNS tumors: OR, 1.83 [95% CI, 1.00-3.34]). Among survivors of non-CNS tumors, serious hearing loss was associated with 2-fold increased risk of nonindependent living (OR, 2.19; 95% CI, 1.19-4.04) and unemployment or not graduating from high school (OR, 1.85; 95% CI, 1.00-3.34). CONCLUSIONS A substantial proportion of adult survivors of childhood cancer treated with potentially ototoxic therapy have serious hearing loss. Treatment-induced hearing loss was found to be associated with reduced social attainment, both perceived and actual, in this study sample.
Collapse
Affiliation(s)
- Tara M. Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Johnnie K. Bass
- Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN
| | - Zhenghong Li
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Amar Gajjar
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Alberto S. Pappo
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Gregory T. Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Thomas E. Merchant
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | | | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - James G. Gurney
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
- School of Public Health, University of Memphis, TN
| |
Collapse
|
26
|
Abstract
BACKGROUND Platinum-based chemotherapy and cranial radiation are effective treatment options commonly prescribed for a variety of childhood cancers. These therapies can, and often do, result in early- and late-onset adverse health effects such as hearing loss. Undetected hearing loss is particularly concerning in young children developing speech and language skills and can negatively affect academic achievement and the psychosocial well-being of both young and older children. Early detection of hearing loss in pediatric oncology patients and early intervention are critical to help these patients succeed in achieving these developmental milestones. PURPOSE The primary goal of this study was to create a tutorial for audiologists concerning the monitoring of ototoxicity in the pediatric oncology population. Monitoring hearing for children receiving potentially ototoxic cancer treatments presents special issues and challenges for audiologists. This tutorial will orient the reader to these special issues and challenges, and potential solutions will be proposed. DESIGN This tutorial is organized into sections, including an overview of platinum compound and cranial radiation treatments commonly used to treat pediatric cancer, modifications of the test battery required to appropriately monitor for ototoxic hearing loss in children, a proposal for a monitoring protocol, and descriptions of the grading scales that are frequently used by oncologists to determine the severity of ototoxic hearing loss. CONCLUSIONS Identification of ototoxicity is crucial in children receiving cancer treatments because of the impact that acquired hearing loss has on social and educational outcomes in the developing child. Monitoring hearing in children presents challenges that are unique to this population. Much effort has been put forth in developing and validating the International Society of Pediatric Oncology ototoxicity grading scale for international use in reporting auditory outcomes in clinical trials. In the future, the development of standardized monitoring protocols will assist audiologists in providing optimal care to children treated for cancer.
Collapse
Affiliation(s)
- Johnnie K Bass
- University of Memphis, Hearing Science Laboratory, School of Communication Sciences and Disorders, Memphis, TN; St. Jude Children's Research Hospital, Rehabilitation Services, Memphis, TN
| | - Shaum P Bhagat
- University of Memphis, Hearing Science Laboratory, School of Communication Sciences and Disorders, Memphis, TN; St. Jude Children's Research Hospital, Rehabilitation Services, Memphis, TN
| |
Collapse
|
27
|
Xu H, Robinson GW, Huang J, Lim JYS, Zhang H, Bass JK, Broniscer A, Chintagumpala M, Bartels U, Gururangan S, Hassall T, Fisher M, Cohn R, Yamashita T, Teitz T, Zuo J, Onar-Thomas A, Gajjar A, Stewart CF, Yang JJ. Common variants in ACYP2 influence susceptibility to cisplatin-induced hearing loss. Nat Genet 2015; 47:263-6. [PMID: 25665007 PMCID: PMC4358157 DOI: 10.1038/ng.3217] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 01/14/2015] [Indexed: 02/05/2023]
Abstract
Taking a genome-wide association study approach, we identified inherited genetic variations in ACYP2 associated with cisplatin-related ototoxicity (rs1872328: P = 3.9 × 10(-8), hazard ratio = 4.5) in 238 children with newly diagnosed brain tumors, with independent replication in 68 similarly treated children. The ACYP2 risk variant strongly predisposed these patients to precipitous hearing loss and was related to ototoxicity severity. These results point to new biology underlying the ototoxic effects of platinum agents.
Collapse
Affiliation(s)
- Heng Xu
- 1] Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. [2] Department of Laboratory Medicine, National Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Giles W Robinson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jie Huang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Joshua Yew-Suang Lim
- 1] Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. [2] Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Hui Zhang
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Johnnie K Bass
- Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Alberto Broniscer
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | | | - Ute Bartels
- Department of Haematology and Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sri Gururangan
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - Tim Hassall
- Department of Oncology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Michael Fisher
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Richard Cohn
- School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Tetsuji Yamashita
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Tal Teitz
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jian Zuo
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Arzu Onar-Thomas
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Amar Gajjar
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Clinton F Stewart
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jun J Yang
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| |
Collapse
|
28
|
Gurney JG, Bass JK, Onar-Thomas A, Huang J, Chintagumpala M, Bouffet E, Hassall T, Gururangan S, Heath JA, Kellie S, Cohn R, Fisher MJ, Panandiker AP, Merchant TE, Srinivasan A, Wetmore C, Qaddoumi I, Stewart CF, Armstrong GT, Broniscer A, Gajjar A. Evaluation of amifostine for protection against cisplatin-induced serious hearing loss in children treated for average-risk or high-risk medulloblastoma. Neuro Oncol 2014; 16:848-55. [PMID: 24414535 PMCID: PMC4022215 DOI: 10.1093/neuonc/not241] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 11/14/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate amifostine for protection from cisplatin-induced serious hearing loss in patients with average-risk medulloblastoma by extending a previous analysis to a much larger sample size. In addition, this study aimed to assess amifostine with serious hearing loss in patients with high-risk medulloblastoma treated with cisplatin. METHODS Newly diagnosed medulloblastoma patients (n = 379; ages 3-21 years), enrolled on one of 2 sequential St. Jude clinical protocols that included 4 courses of 75 mg/m(2) cisplatin, were compared for hearing loss by whether or not they received 600 mg/m(2) of amifostine immediately before and 3 hours into each cisplatin infusion. Amifostine administration was not randomized. The last audiological evaluation between 5.5 and 24.5 months following protocol treatment initiation was graded using the Chang Ototoxicity Scale. A grade of ≥ 2b (loss requiring a hearing aid or deafness) was considered a serious event. RESULTS Among average-risk patients (n = 263), amifostine was associated with protection from serious hearing loss (adjusted OR, 0.30; 95% CI, 0.14-0.64). For high-risk patients (n = 116), however, there was not sufficient evidence to conclude that amifostine prevented serious hearing loss (OR, 0.89; 95% CI, 0.31-2.54). CONCLUSIONS Although patients in this study were not randomly assigned to amifostine treatment, we found evidence in favor of amifostine administration for protection against cisplatin-induced serious hearing loss in average-risk but not in high-risk, medulloblastoma patients.
Collapse
Affiliation(s)
- James G Gurney
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Johnnie K Bass
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Arzu Onar-Thomas
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Jie Huang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Murali Chintagumpala
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Eric Bouffet
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Tim Hassall
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Sridharan Gururangan
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - John A Heath
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Stewart Kellie
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Richard Cohn
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Michael J Fisher
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Atmaram Pai Panandiker
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Thomas E Merchant
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Ashok Srinivasan
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Cynthia Wetmore
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Ibrahim Qaddoumi
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Clinton F Stewart
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Alberto Broniscer
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Amar Gajjar
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| |
Collapse
|
29
|
Bass JK, Huang J, Onar-Thomas A, Chang KW, Bhagat SP, Chintagumpala M, Bartels U, Gururangan S, Hassall T, Heath JA, McCowage G, Cohn RJ, Fisher MJ, Robinson G, Broniscer A, Gajjar A, Gurney JG. Concordance between the chang and the International Society of Pediatric Oncology (SIOP) ototoxicity grading scales in patients treated with cisplatin for medulloblastoma. Pediatr Blood Cancer 2014; 61:601-5. [PMID: 24504791 PMCID: PMC4371725 DOI: 10.1002/pbc.24830] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 09/27/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND Reporting ototoxicity is frequently complicated by use of various ototoxicity criteria. The International Society of Pediatric Oncology (SIOP) ototoxicity grading scale was recently proposed for standardized use in reporting hearing loss outcomes across institutions. The aim of this study was to evaluate the concordance between the Chang and SIOP ototoxicity grading scales. Differences between the two scales were identified and the implications these differences may have in the clinical setting were discussed. PROCEDURES Audiological evaluations were reviewed for 379 patients with newly diagnosed medulloblastoma (ages 3-21 years). Each patient was enrolled on one of two St. Jude clinical protocols that included craniospinal radiation therapy and four courses of 75 mg/m(2) cisplatin chemotherapy. The latest audiogram conducted 5.5-24.5 months post-protocol treatment initiation was graded using the Chang and SIOP ototoxicity criteria. Clinically significant hearing loss was defined as Chang grade ≥2a and SIOP ≥2. Hearing loss was considered serious (requiring a hearing aid) at the level of Chang grade ≥2b and SIOP ≥3. RESULTS A strong concordance was observed between the Chang and SIOP ototoxicity scales (Stuart's tau-c statistic = 0.89, 95% CI: 0.86, 0.91). Among those patients diagnosed with serious hearing loss, the two scales were in good agreement. However, the scales deviated from one another in classifying patients with less serious or no hearing loss. CONCLUSIONS Although discrepancies between the Chang and SIOP ototoxicity scales exist primarily for patients with no or minimal hearing loss, the scales share a strong concordance overall.
Collapse
Affiliation(s)
- Johnnie K. Bass
- Rehabilitation Services, St Jude Children’s Research Hospital, Memphis TN,School of Communication Sciences and Disorders, University of Memphis, Memphis TN
| | - Jie Huang
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis TN
| | - Arzu Onar-Thomas
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis TN
| | - Kay W. Chang
- Department of Otolaryngology, Stanford University, Stanford CA
| | - Shaum P. Bhagat
- Rehabilitation Services, St Jude Children’s Research Hospital, Memphis TN,School of Communication Sciences and Disorders, University of Memphis, Memphis TN
| | | | | | | | | | | | | | | | | | - Giles Robinson
- Department of Oncology, St Jude Children’s Research Hospital, Memphis TN
| | - Alberto Broniscer
- Department of Oncology, St Jude Children’s Research Hospital, Memphis TN
| | - Amar Gajjar
- Department of Oncology, St Jude Children’s Research Hospital, Memphis TN
| | - James G. Gurney
- Department of Epidemiology and Cancer Control, St Jude Children’s Research Hospital, Memphis TN,School of Public Health, University of Memphis, Memphis TN
| |
Collapse
|
30
|
Schreiber JE, Gurney JG, Palmer SL, Bass JK, Wang M, Chen S, Zhang H, Swain M, Chapieski ML, Bonner MJ, Mabbott DJ, Knight SJ, Armstrong CL, Boyle R, Gajjar A. Examination of risk factors for intellectual and academic outcomes following treatment for pediatric medulloblastoma. Neuro Oncol 2014; 16:1129-36. [PMID: 24497405 DOI: 10.1093/neuonc/nou006] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The aim of this study was to prospectively examine the effects of hearing loss and posterior fossa syndrome (PFS), in addition to age at diagnosis and disease risk status, on change in intellectual and academic outcomes following diagnosis and treatment in a large sample of medulloblastoma patients. METHODS Data from at least 2 cognitive and academic assessments were available from 165 patients (ages 3-21 years) treated with surgery, risk-adapted craniospinal irradiation, and 4 courses of chemotherapy with stem cell support. Patients underwent serial evaluation of cognitive and academic functioning from baseline up to 5 years post diagnosis. RESULTS Serious hearing loss, PFS, younger age at diagnosis, and high-risk status were all significant risk factors for decline in intellectual and academic skills. Serious hearing loss and PFS independently predicted below-average estimated mean intellectual ability at 5 years post diagnosis. Patients with high-risk medulloblastoma and young age at diagnosis (<7 years) exhibited the largest drop in mean scores for intellectual and academic outcomes. CONCLUSIONS Despite a significant decline over time, intellectual and academic outcomes remained within the average range at 5 years post diagnosis for the majority of patients. Future studies should determine if scores remain within the average range at time points further out from treatment. Patients at heightened risk should be closely monitored and provided with recommendations for appropriate interventions.
Collapse
Affiliation(s)
- Jane E Schreiber
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - James G Gurney
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Shawna L Palmer
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Johnnie K Bass
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Mingjuan Wang
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Si Chen
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Hui Zhang
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Michelle Swain
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Mary L Chapieski
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Melanie J Bonner
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Donald J Mabbott
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Sarah J Knight
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Carol L Armstrong
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Robyn Boyle
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Amar Gajjar
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| |
Collapse
|
31
|
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] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
32
|
Qaddoumi I, Bass JK, Wu J, Billups CA, Wozniak AW, Merchant TE, Haik BG, Wilson MW, Rodriguez-Galindo C. Carboplatin-associated ototoxicity in children with retinoblastoma. J Clin Oncol 2012; 30:1034-41. [PMID: 22370329 PMCID: PMC3341147 DOI: 10.1200/jco.2011.36.9744] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 11/02/2011] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Carboplatin-induced ototoxicity remains poorly defined but is of potential great consequence in children with retinoblastoma. We retrospectively assessed the incidence of ototoxicity and its risk factors in children with retinoblastoma who were treated with carboplatin. PATIENTS AND METHODS We reviewed the audiologic test results of 60 patients with retinoblastoma who received front-line treatment with systemic carboplatin and vincristine according to the St Jude RET-3 protocol (n = 23) or best clinical management (n = 37). Ototoxicity was evaluated by three different grading systems. RESULTS Twelve patients (20%) developed ototoxicity at some time after treatment initiation; however, ototoxicity resolved in two patients, and thus,10 patients (17%) had sustained hearing loss as documented at their most recent audiologic evaluation. Nine of these 10 patients had grade 3 or 4 ototoxicity, and nine patients were less than 6 months of age at the start of chemotherapy. Age at the start of chemotherapy was the only risk factor identified as a significant predictor of sustained hearing loss. Younger age was associated with an increased incidence of hearing loss. The different ototoxicity grading systems showed good overall agreement in the identification of patients with ototoxicity. Agreement was greatest between the Brock and Children's Cancer Group systems. CONCLUSION We found that young patients with retinoblastoma who were treated with systemic carboplatin had a higher incidence of ototoxicity than previously reported. Younger patients (< 6 months of age at the start of treatment) were more likely to have ototoxicity than were older patients. Children treated with carboplatin should routinely undergo thorough, long-term audiologic monitoring.
Collapse
Affiliation(s)
- Ibrahim Qaddoumi
- St Jude Children's Research Hospital, Memphis, TN 38105-3678, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Hua C, Bass JK, Khan R, Kun LE, Merchant TE. Hearing loss after radiotherapy for pediatric brain tumors: effect of cochlear dose. Int J Radiat Oncol Biol Phys 2008; 72:892-9. [PMID: 18395355 DOI: 10.1016/j.ijrobp.2008.01.050] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2007] [Revised: 01/31/2008] [Accepted: 01/31/2008] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the effect of cochlear dose on sensorineural hearing loss in pediatric patients with brain tumor treated by using conformal radiation therapy (CRT). PATIENTS AND METHODS We studied 78 pediatric patients (155 ears) with localized brain tumors treated in 1997-2001 who had not received platinum-based chemotherapy and were followed up for at least 48 months. They were evaluated prospectively by means of serial pure-tone audiograms (250 Hz-8 kHz) and/or auditory brainstem response before and every 6 months after CRT. RESULTS Hearing loss occurred in 14% (11 of 78) of patients and 11% (17 of 155) of cochleae, with onset most often at 3-5 years after CRT. The incidence of hearing loss was low for a cochlear mean dose of 30 Gy or less and increased at greater than 40-45 Gy. Risk was greater at high frequencies (6-8 kHz). In children who tested abnormal for hearing, average hearing thresholds increased from a less than 25 decibel (dB) hearing level (HL) at baseline to a mean of 46 +/- 13 (SD) dB HL for high frequencies, 41 +/- 7 dB HL for low frequencies, and 38 +/- 6 dB HL for intermediate frequencies. CONCLUSIONS Sensorineural hearing loss is a late effect of CRT. In the absence of other factors, including ototoxic chemotherapy, increase in cochlear dose correlates positively with hearing loss in pediatric patients with brain tumor. To minimize the risk of hearing loss for children treated with radiation therapy, a cumulative cochlear dose less than 35 Gy is recommended for patients planned to receive 54-59.4 Gy in 30-33 treatment fractions.
Collapse
Affiliation(s)
- Chiaho Hua
- Division of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | | | | | | |
Collapse
|
34
|
Abstract
OBJECTIVE Since very little is known about the health effects that household pesticides have on children, we conducted this survey to identify what pesticides are being used in the home, where they are being used and stored, and what methods are used for their disposal. METHODS In the spring of 1999 we conducted a survey in a community in the state of Arizona, in the United States of America, on the border with Mexico. To be eligible to participate in the survey, households had to have used a pesticide in the 6 mo prior to the survey and to have at least one child under the age of 10 years. We gathered general information on pesticide usage, storage, and disposal, in addition to specific information about each of the pesticides currently being used and/or stored in the home. RESULTS In the 107 households surveyed, we found 148 pesticide products, for a mean of 1.4 per household. Half of the pesticides were stored less than 4 feet (1.22 m) from the ground, at a level a child could reach. Seventy percent of all the pesticides were stored inside the home, with the kitchen being the storage room most often mentioned. The kitchen was also the room where most of the pesticides were used, with 69% of the respondents saying they had used at least one pesticide there. CONCLUSIONS From our research we conclude that it will be important to continue to investigate all avenues of pesticide exposure in order to fully evaluate childhood exposures. Understanding household pesticide use and developing a model of exposure will help in this process. Profiles of the use, storage, and disposal of products will also guide the development of effective education and poison prevention programs in the community.
Collapse
Affiliation(s)
- J K Bass
- Centers for Disease Control and Prevention, National Center for Environmental Health, Health Studies Branch, 1600 Clifton Road NE (Mailstop E-23), Atlanta, Georgia 30333, USA
| | | | | | | | | |
Collapse
|
35
|
Bass JK. Down a twisted path. Nebr Nurse 1997; 30:37. [PMID: 9400230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
36
|
Abstract
Nickel is one of the most common causes of allergic contact dermatitis and produces more allergic reactions than all other metals combined. Currently, several brands of orthodontic wires are made of nickel titanium alloy and potentially have a high enough nickel content to provoke manifestations of allergic reactions in the oral cavity. The objectives of this study were (1) to determine if standard orthodontic therapy can sensitize patients to nickel, and (2) to assess gingival response to nickel-containing orthodontic appliances in patients who are nickel sensitive before treatment. Nickel sensitivity patch tests were conducted to confirm hypersensitivity to nickel. Twenty-nine patients from the Division of Orthodontics, Albert Einstein/Montefiore Medical Center were tested, ranging in age from 12 to 48 years. Of the 29 patients, there were 18 female and 11 males. Five of the patients had a positive nickel patch test, a rate of 18.5%. The five patients that tested positive were all female, meaning that the overall rate for females was 27.7% (5:18). The five female patients sensitive to nickel were followed monthly by intraoral photos and gingival and plaque index scores. The remaining patients began routine orthodontic therapy and were retested 3 months into treatment to see whether sensitization occurred. Two patients converted from an initial negative patch test to a positive test. There may be a risk of sensitizing patients to nickel with long-term exposure to nickel-containing appliances as occurs in routine orthodontic therapy.
Collapse
Affiliation(s)
- J K Bass
- Albert Einstein and Montefiore Medical Center, Bronx, N.Y
| | | | | |
Collapse
|