Cisplatin is one of the most effective chemotherapy agents, used in just under half of pediatric cancer cases. Permanent hearing loss is a common side effect of this medication, but until now, studies have been too small and too varied to accurately characterize this risk. Today in The Lancet Child & Adolescent Health, investigators at Children's Hospital Los Angeles published results of the largest study of cisplatin-induced hearing loss to date. The study establishes the first benchmarks for the prevalence of hearing loss, and reveals that the risk of hearing loss is affected not only by how much drug is given, but by how that drug is delivered—dosing schedules, complementary treatments, and more. These findings will allow oncologists to deliver more information to patients, and to plan treatment schedules to minimize this side effect. The large number of variables involve means that permanent hearing loss can occur in anywhere from 20-90% of cisplatin-treated patients. This variable range is due to the fact that circumstances differ for many patients (their age, cancer type and other factors). But the new study reveals that another important aspect of chemotherapy can impact a child's risk for hearing loss. "We found that how we infuse the drug can significantly alter the risk of side effects," says Etan Orgel, MD, MS, who designed and led the study. "Cisplatin has been used to treat cancers in children and adults for more than fifty years, but for the first time, we have insights into how something as simple as adjusting our dosing approach may prevent hearing loss and still maintain effective treatments." Source
