Analysis of Hearing Thresholds of the Onco-Pediatric Population Submitted to Chemotherapy Treatment

Authors

  • Camila Franciozi Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Programa de Pós-Graduação em Patologia. Porto Alegre (RS), Brasil. https://orcid.org/0000-0002-9079-972X
  • Viviann Magalhães Silva Borges Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente. Porto Alegre (RS), Brasil. https://orcid.org/0000-0002-5705-753X
  • Letícia Gregory Instituto do Câncer Infantil do Rio Grande do Sul, Núcleo de Atendimento ao Paciente. Porto Alegre (RS), Brasil. https://orcid.org/0000-0002-7545-9559
  • Paulo Ricardo Gazzola Zen Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Departamento de Clínica Médica. Porto Alegre (RS), Brasil. https://orcid.org/0000-0002-7628-4877
  • Lauro José Gregianin Instituto do Câncer Infantil do Rio Grande do Sul. Porto Alegre (RS), Brasil https://orcid.org/0000-0003-0788-7858
  • Pricila Sleifer Universidade Federal do Rio Grande do Sul (UFRGS), Instituto de Psicologia, Departamento de Saúde e Comunicação Humana. Porto Alegre (RS), Brasil. https://orcid.org/0000-0001-6694-407X

DOI:

https://doi.org/10.32635/2176-9745.RBC.2025v71n2.4804

Keywords:

Hearing/drug effects, Child, Antineoplastic Agents/adverse effects, Ototoxicity

Abstract

Introduction: Fast and effective treatments are essential for pediatric patients with cancer due to its high risk of mortality. However, the treatment can cause severe side effects, including ototoxicity. Objective: To investigate the effect of chemotherapy on hearing thresholds of
pediatric patients with cancer and to identify the presence of hearing complaints, psychoacoustic thresholds by frequency and the relations between hearing diagnosis and the variables age, sex and ear (left or right). Method: Cross-sectional, observational and contemporary
study. Hearing thresholds of 42 children diagnosed with cancer of both sexes, 17 females and 25 males, aged between seven and 11 years
old and 11 months were investigated. All children underwent pure tone audiometry for peripheral audiological assessment. Results: The
sample’s mean age was 8.7 years (SD = 1.08). Six children were diagnosed with sensorineural hearing loss (14.3%) and one with conductive hearing loss (2.4%). Borderline hearing thresholds were identified in 31 children (73.8%). Conclusion: Changes of hearing thresholds of
the sample investigated were associated with chemotherapy exposure. There was a higher prevalence of borderline thresholds and left-ear hearing loss in males, predominantly in the age range of eight years old.

Downloads

Download data is not yet available.

References

Hu Z, Li Z, Ma Z, et al. Multi-cancer analysis of clonality and the timing of systemic spread in paired primary tumors and metastases. Nat Genet. 2020;52(7):701-8. doi: https://doi.org/10.1038/s41588-020-0628-z DOI: https://doi.org/10.1038/s41588-020-0628-z

Filbin M, Monje M. Developmental origins and emerging therapeutic opportunities for childhood cancer. Nat Med. 2019;25(3):367-76. doi: https://doi.org/10.1038/s41591-019-0383-9 DOI: https://doi.org/10.1038/s41591-019-0383-9

Kagami L, Baldino S, MacFarland SP. Childhood cancer predisposition: an overview for the general pediatrician. Pediatr Ann. 2022;51(1):e15-21. doi: https://doi.org/10.3928/19382359-20211207-01 DOI: https://doi.org/10.3928/19382359-20211207-01

Spironello RA, Silva FMS, Cardia GFE, et al. Mortalidade infantil por câncer no Brasil. Saúde Pesqui. 2020;13(1):115-22. doi: https://doi.org/10.17765/2176-9206.2020v13n1p115-122 DOI: https://doi.org/10.17765/2176-9206.2020v13n1p115-122

Instituto Nacional de Câncer [Internet]. Rio de Janeiro: INCA; [2000]. Tipos de câncer, 2022 jun 4 atualizado em 2023 jan 13. Disponível em: https://www.gov.br/inca/pt-br/assuntos/cancer/tipos/infantojuvenil

Feliciano SVM, Santos MO, Pombo-de-Oliveira MS. Incidência e mortalidade por câncer entre crianças e adolescentes: uma revisão narrativa. Rev Bras Cancerol. 2018;64(3):389-96. doi: https://doi.org/10.32635/2176-9745.RBC.2018v64n3.45 DOI: https://doi.org/10.32635/2176-9745.RBC.2018v64n3.45

Santos MO, Lima FCS, Martins LFL, et al. Estimativa de incidência de câncer no Brasil, 2023-2025. Rev Bras Cancerol. 2023;69(1):e-213700. doi: https://doi.org/10.32635/2176-9745.RBC.2023v69n1.3700 DOI: https://doi.org/10.32635/2176-9745.RBC.2023v69n1.3700

van As JW, van den Berg H, van Dalen EC. Platinum-induced hearing loss after treatment for childhood cancer. Cochrane Database Syst Rev. 2016;2016(8):CD010181. doi: https://doi.org/10.1002/14651858.CD010181.pub2 DOI: https://doi.org/10.1002/14651858.CD010181.pub2

Lopes NB, Silva LAF, Samelli AG, et al. Effects of chemotherapy on the auditory system of children with cancer: a systematic literature review. Rev CEFAC. 2020;22(2):e13919. doi: https://doi.org/10.1590/1982-0216/202022213919 DOI: https://doi.org/10.1590/1982-0216/202022213919

Patatt FSA, Gonçalves LF, Paiva KM, et al. Ototoxic effects of antineoplastic drugs: a systematic review. Braz J Otorhinolaryngol. 2022;88(1):130-40. doi: https://doi.org/10.1016/j.bjorl.2021.02.008 DOI: https://doi.org/10.1016/j.bjorl.2021.02.008

Landier W. Ototoxicity and cancer therapy. Cancer. 2016;122(11):1647-58. doi: https://doi.org/10.1002/cncr.29779 DOI: https://doi.org/10.1002/cncr.29779

Bhagat SP, Bass JK, White ST, et al. Monitoring carboplatin ototoxicity with distortion-product otoacoustic emissions in children with retinoblastoma. Int J Pediatr Otorhinolaryngol. 2010;74(10):1156-63. doi: https://doi.org/10.1016/j.ijporl.2010.07.004 DOI: https://doi.org/10.1016/j.ijporl.2010.07.004

Al-Noury K. Distortion product otoacoustic emission for the screening of cochlear damage in children treated with cisplatin. Laryngoscope. 2011;121(5):1081-4. doi: https://doi.org/10.1002/lary.21740 DOI: https://doi.org/10.1002/lary.21740

Sousa LCA, Piza MRT, Alvarenga K, et al. Eletrofisiologia da audição e emissões otoacústicas: princípios e aplicações clínicas. 2. ed. Ribeirão Preto: Editora Novo Conceito; 2010.

Sanfins MD, Hein TAD, Ubiali T, et al. Emissões otoacústicas transientes e por produto de distorção. In: Menezes PL, Sanfins MD, Capra D, et al., organizadores. Manual de eletrofisiologia e eletroacústica: um guia para clínicos. Ribeirão Preto: BookToy; 2022. p. 69-82.

Paulino AC, Lobo M, Teh BS, et al. Ototoxicity after intensity-modulated radiation therapy and cisplatin-based chemotherapy in children with medulloblastoma. Int J Radiat Oncol Biol Phys. 2010;78(5):1445-50. doi: https://doi.org/10.1016/j.ijrobp.2009.09.031 DOI: https://doi.org/10.1016/j.ijrobp.2009.09.031

Einarsson JE, Petersen H, Wiebe T, et al. Long term hearing degeneration after platinum-based chemotherapy in childhood. Int J Audiol. 2010;49(10):765-71. doi: https://doi.org/10.3109/14992027.2010.485595 DOI: https://doi.org/10.3109/14992027.2010.485595

Bertolini P, Lassalle M, Mercier G, et al. Platinum compound-related ototoxicity in children: long-term follow-up reveals continuous worsening of hearing loss. J Pediatr Hematol Oncol. 2004;26(10):649-55. doi: https://doi.org/10.1097/01.mph.0000141348.62532.73 DOI: https://doi.org/10.1097/01.mph.0000141348.62532.73

Almeida EOC, Umeoka WG, Viera RC, et al. Estudo audiometrico de alta fraquência em pacientes curados de câncer tratados com cisplatina. Rev Bras Otorrinolaringol. 2008;74(3):382-90. doi: https://doi.org/10.1590/S0034-72992008000300012 DOI: https://doi.org/10.1590/S0034-72992008000300012

Clemens E, Vries CHA, Zehnhoff-Dinnesenc, A, et al. Determinants of ototoxicity in 451 platinum-treated Dutch survivors of childhood cancer: a DCOG late-effects study. Eur J Cancer. 2016;69:77-85. doi: https://doi.org/10.1016/j.ejca.2016.09.023 DOI: https://doi.org/10.1016/j.ejca.2016.09.023

Konrad-Martin D, Polaski R, DeBacker JR, et al. Audiologists’ perceived value of ototoxicity management and barriers to implementation for at-risk cancer patients in VA: the OtoMIC survey. J Cancer Surviv. 2023;17(1):69-81. doi: https://doi.org/10.1007/s11764-022-01316-7 DOI: https://doi.org/10.1007/s11764-022-01316-7

Andrade V, Khoza-Shangase K, Hajat F. Perceptions of oncologists at two state hospitals in Gauteng regarding the ototoxic effects of cancer chemotherapy: a pilot study. Afr J Pharmacy Pharmacol. 2009;3:307-18. doi: https://doi.org/10.5897/AJPP.9000214

Wells RHC, Bay-Nielsen H, Braun R, et al. CID-10: classificação estatística internacional de doenças e problemas relacionados à saúde. São Paulo: EDUSP; 2011.

Steliarova-Foucher E, Stiller C, Lacour B, et al. International classification of childhood cancer, third edition. Cancer. 2005;103(7):1457-67. https://doi.org/10.1002/cncr.20910 DOI: https://doi.org/10.1002/cncr.20910

Organização Mundial da Saúde. Basic ear and hearing care resource [Internet]. Geneva: WHO; 2020. [acesso 2022 dez 20]. Disponível em: http://www.who.int/pbd/deafness/hearing_impairment_grades/en

Russo ICAP, Santos TMM. A prática da audiologia clínica. São Paulo: Cortez, 2011.

RStudio [Internet]. Version 2020.12.0+353. Boston: Posit Software, PBC. 2024 abr 1 - [acesso 2023 abr 10]. Disponível em: http://www.rstudio.com/ide

R: The R Project for Statistical Computing [Internet]. Version 4.2.2 [sem local]: The R foundation. 2021 nov 2 - [acesso 2023 abr 10]. Disponível em: https://www.r-project.org/

Conselho Nacional de Saúde (BR). Resolução n° 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União, Brasília, DF. 2013 jun 13; Seção I:59.

Wu Y, Deng Y, Wei B, et al. Global, regional, and national childhood cancer burden, 1990-2019: an analysis based on the Global Burden of Disease Study 2019. J Adv Res. 2022;40:233-47. doi: https://doi.org/10.1016/j.jare.2022.06.001 DOI: https://doi.org/10.1016/j.jare.2022.06.001

Liu Z, Yang Q, Cai N, et al. Enigmatic differences by sex in cancer incidence: evidence from childhood cancers. Am J Epidemiol. 2019;188(6):1130-5. doi: https://doi.org/10.1093/aje/kwz058 DOI: https://doi.org/10.1093/aje/kwz058

Corbin NE, Buss E, Leibold LJ. Spatial hearing and functional auditory skills in children with unilateral hearing loss. J Speech Lang Hear Res. 2021;64(11):4495-512. doi: https://doi.org/10.1044/2021_JSLHR-20-00081 DOI: https://doi.org/10.1044/2021_JSLHR-20-00081

Vila PM, Lieu JE. Asymmetric and unilateral hearing loss in children. Cell Tissue Res. 2015;361(1):271-8. doi: https://doi.org/10.1007/s00441-015-2208-6 DOI: https://doi.org/10.1007/s00441-015-2208-6

Bess FH, Davis H, Camarata S, et al. Listening-related fatigue in children with unilateral hearing loss. Lang Speech Hear Serv Sch. 2020;51(1):84-97. doi: https://doi.org/10.1044/2019_LSHSS-OCHL-19-0017 DOI: https://doi.org/10.1044/2019_LSHSS-OCHL-19-0017

Carpenter D, Dougherty W, Sindhar S, et al. Are children with unilateral hearing loss more tired? Int J Pediatr Otorhinolaryngol. 2022;155:111075. doi: https://doi.org/10.1016/j.ijporl.2022.111075 DOI: https://doi.org/10.1016/j.ijporl.2022.111075

Restuti RD, Sriyana AA, Priyono H, et al. Chronic suppurative otitis media and immunocompromised status in paediatric patients. Med J Malaysia. 2022;77(5):619-21.

Dror T, Akerman M, Noor A, et al. Seasonal variation of respiratory viral infections: a comparative study between children with cancer undergoing chemotherapy and children without cancer. Pediatr Hematol Oncol, 2021;38(5), 444-55. doi: https://doi.org/10.1080/088 DOI: https://doi.org/10.1080/08880018.2020.1871137

2020.1871137

Brock PR, Knight KR, Freyer DR, et al. Platinum-induced ototoxicity in children: a consensus review on mechanisms, predisposition, and protection, including a new International Society of Pediatric Oncology Boston ototoxicity scale. J Clin Oncol. 2012;30(19):2408-17.

doi: https://doi.org/10.1200/JCO.2011.39.1110 DOI: https://doi.org/10.1200/JCO.2011.39.1110

Beyea JA, Lau C, Cooke B, et al. Long-term incidence and predictors of significant hearing loss requiring hearing assistive devices among childhood cancer survivors: a population-based study. J Clin Oncol. 2020;38(23):2639-46. doi: https://doi.org/10.1200/JCO.19.03166 DOI: https://doi.org/10.1200/JCO.19.03166

Phelan M, Hayashi SS, Sauerburger K, et al. Prevalence of hearing screening failures in low-risk childhood cancer survivors. Pediatr Blood Cancer. 2022;69(2):e29437. doi: https://doi.org/10.1002/pbc.29437 DOI: https://doi.org/10.1002/pbc.29437

Knobel KAB, Lima MCMP. Are parents aware of their children’s hearing complaints? Braz J Otorhinolaryngol. 2012;78(5):27-37 DOI: https://doi.org/10.5935/1808-8694.20120005

Meijer AJM, Clemens E, Hoetink AE, et al. Tinnitus during and after childhood cancer: a systematic review. Crit Rev Oncol Hematol. 2019;135:1-7. doi: https://doi.org/10.1016/j.critrevonc.2019.01 DOI: https://doi.org/10.1016/j.critrevonc.2019.01.004

Sánchez-Canteli M, Núñez-Batalla F, Martínez-González P, et al. Ototoxicity in cancer survivors: experience and proposal of a surveillance protocol. An Pediatr (Engl Ed). 2020;95(5):290-7. doi: https://doi.org/10.1016/j.anpedi.2020.08.008 DOI: https://doi.org/10.1016/j.anpede.2020.08.014

Clemens E, van den Heuvel-Eibrink MM, Mulder RL, et al. 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 thePanCare Consortium. Lancet Oncol. 2019;20(1):e29-41. doi: https://doi.org/10.1016/S1470-204 DOI: https://doi.org/10.1016/S1470-2045(18)30858-1

Published

2025-04-28

How to Cite

1.
Franciozi C, Borges VMS, Gregory L, Zen PRG, Gregianin LJ, Sleifer P. Analysis of Hearing Thresholds of the Onco-Pediatric Population Submitted to Chemotherapy Treatment. Rev. Bras. Cancerol. [Internet]. 2025 Apr. 28 [cited 2025 Dec. 5];71(2):e-074804. Available from: https://rbc.inca.gov.br/index.php/revista/article/view/4804

Issue

Section

ORIGINAL ARTICLE

Most read articles by the same author(s)