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The impact of the temporal sequence of cranial radiotherapy and platin-based chemotherapy on hearing impairment in pediatric and adolescent CNS and head-and-neck cancer patients: A report from the PanCareLIFE consortium |
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| Authors: | Sergiu Scobioala Ross Parfitt Peter Matulat Julianne Byrne Thorsten Langer Fabian M. Troschel Amélie E. Hesping Eva Clemens Peter Kaatsch Desiree Grabow Melanie Kaiser Claudia Spix Leontien C. Kremer Gabriele Calaminus Katja Baust Claudia E. Kuehni Annette Weiss Sven Strebel Rahel Kuonen Susanne Elsner Riccardo Haupt Maria-Luisa Garré Bernd Gruhn Tomas Kepak Katerina Kepakova Jeanette Falck Winther Line Kenborg Catherine Rechnitzer Henrik Hasle Jarmila Kruseova Ales Luks Herwig Lackner Stefan Bielack Jörn-Dirk Beck Heribert Jürgens Marry M. van den Heuvel-Eibrink Oliver Zolk Hans Theodor Eich Antoinette am Zehnhoff-Dinnesen the PanCareLIFE Consortium |
| Affiliation: | 1. Clinic for Radiotherapy, Radiooncology University Hospital Muenster, Muenster, Germany;2. Department for Phoniatrics and Pedaudiology, University Hospital, Muenster, UKM, Germany;3. Boyne Research Institute, Drogheda, Ireland;4. Pediatric Oncology and Hematology, University Hospital for Children and Adolescents, University of Luebeck, Luebeck, Germany;5. Erasmus University Medical Centre (EMC), Rotterdam, The Netherlands;6. German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany;7. Division of Childhood Cancer Epidemiology, German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany;8. Academisch Medisch Centrum bij de Universiteit van Amsterdam (AMC), Amsterdam, The Netherlands Princess Maxima Center for Pediatric Oncology (PMC), and University of Utrecht, Utrecht, The Netherlands;9. Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany;10. Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;11. Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland;12. DOPO Clinic and Neuroncology Unit, Department of Hematology/Oncology, IRCCS Istituto Giannina Gaslini (IGG), Genoa, Italy;13. Department of Pediatrics, Jena University Hospital, Jena, Germany;14. International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic Department of Paediatric Oncology, University Hospital Brno, Brno, Czech Republic;15. Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark;16. Pediatric and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark;17. Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark;18. Motol Teaching Hospital, Prague, Czech Republic;19. Pediatric Hematology and Oncology, Medical University of Graz, Graz, Austria;20. Pediatrics 5 (Oncology, Hematology, Immunology), Center for Pediatric, Adolescent, and Women's Medicine, Stuttgart Cancer Center, Klinikum Stuttgart—Olgahospital, Stuttgart, Germany;21. Pediatric Oncology, University Hospital Erlangen, Erlangen, Germany;22. Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany;23. Princess Maxima Center for Pediatric Oncology (PMC), and University of Utrecht, Utrecht, The Netherlands;24. Institute of Clinical Pharmacology, Brandenburg Medical School, Rüdersdorf, Germany |
| Abstract: | The impact of the temporal sequence by which cranial radiotherapy (CRT) and platin-based chemotherapy (PCth) are administered on sensorineural hearing loss (SNHL) in pediatric and adolescent central nervous system (CNS) and head-and-neck (HN) cancer patients has not yet been studied in detail. We examined the ototoxic effects of sequentially applied CRT and PCth. This study included children and adolescents with CNS and HN tumors who participated in the multicountry PanCareLIFE (PCL) consortium. Audiological outcomes were compared between patients who received CRT prior to PCth and those who received it afterwards. The incidence, degree and posttreatment progression of SNHL, defined as Muenster classification grade ≥MS2b, were evaluated in 141 patients. One hundred and nineteen patients were included in a time-to-onset analysis. Eighty-eight patients received CRT prior to PCth (Group 1) and 53 patients received PCth before CRT (Group 2). Over a median follow-up time of 1.6 years, 72.7% of patients in Group 1 experienced SNHL ≥ MS2b compared to 33.9% in Group 2 (P < .01). A time-to-onset analysis was performed for 74 patients from Group 1 and 45 patients from Group 2. Median time to hearing loss (HL) ≥ MS2b was 1.2 years in Group 1 and 4.4 years in Group 2 (P < .01). Thus, audiological outcomes were better for patients who received CRT after PCth than before. This finding should be further evaluated and considered within clinical practice in order to minimize hearing loss in children and adolescents with CNS and HN tumors. |
| Keywords: | cranial radiotherapy PanCareLIFE project platin-based chemotherapy posttreatment hearing loss therapy sequence |