Monitoring carboplatin ototoxicity with distortion-product otoacoustic emissions in children with retinoblastoma

Shaum P. Bhagat, Johnnie K. Bass, Stephanie T. White, Ibrahim Qaddoumi, Matthew W. Wilson, Jianrong Wu, Carlos Rodriguez-Galindo

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Objective: Carboplatin is a common chemotherapy agent with potential ototoxic side effects that is used to treat a variety of pediatric cancers, including retinoblastoma. Retinoblastoma is a malignant tumor of the retina that is usually diagnosed in young children. Distortion-product otoacoustic emission tests offer an effective method of monitoring for ototoxicity in young children. This study was designed to compare measurements of distortion-product otoacoustic emissions obtained before and after several courses of carboplatin chemotherapy in order to examine if (a) mean distortion-product otoacoustic emission levels were significantly different; and (b) if criterion reductions in distortion-product otoacoustic emission levels were observed in individual children. Methods: A prospective repeated measures study. Ten children with a median age of 7.6 months (range, 3-72 months) diagnosed with unilateral or bilateral retinoblastoma were examined. Distortion-product otoacoustic emissions were acquired from both ears of the children with 65/55dB SPL primary tones (f2=793-7996Hz) and a frequency resolution of 3 points/octave. Distortion-product otoacoustic emission levels in dB SPL were measured before chemotherapy treatment (baseline measurement) and after 3-4 courses of chemotherapy (interim measurement). Comparisons were made between baseline and interim distortion-product otoacoustic emission levels (collapsed across ears). Evidence of ototoxicity was based on criterion reductions (≥6dB) in distortion-product otoacoustic emission levels. Results: Significant differences between baseline and interim mean distortion-product otoacoustic emission levels were only observed at f2=7996Hz. Four children exhibited criterion reductions in distortion-product otoacoustic emission levels. Conclusions: Mean distortion-product otoacoustic emission levels at most frequencies were not changed following 3-4 courses of carboplatin chemotherapy in children with retinoblastoma. However, on an individual basis, children receiving higher doses of carboplatin exhibited criterion reductions in distortion-product otoacoustic emission level at several frequencies. These findings suggest that higher doses of carboplatin affect outer hair cell function, and distortion-product otoacoustic emission tests can provide useful information when monitoring children at risk of developing carboplatin ototoxicity.

Original languageEnglish
Pages (from-to)1156-1163
Number of pages8
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume74
Issue number10
DOIs
StatePublished - Oct 2010

Bibliographical note

Funding Information:
We wish to thank Tammy Free and Vicki Given for their contributions to this project. Portions of this report were presented at the American Auditory Society meeting, March 5–7, 2009 in Scottsdale, Arizona and at the MidWinter Research Meeting of the Association for Research in Otolaryngology, February 6–10, 2010 in Anaheim, California. This work was supported in part by grants CA 21765 and CA 23099 from the U.S. Public Health Service and by the American Lebanese Syrian Associated Charities (ALSAC) . The sponsors had no role in the collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.

Keywords

  • Carboplatin
  • Child
  • Cochlea
  • Hearing
  • Retinoblastoma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology

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