Carboplatin-Associated Ototoxicity in Children With Retinoblastoma

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.

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Prospective evaluation of multitarget treatment of pediatric patients with helical intensity-modulated radiotherapy

Strahlentherapie und Onkologie ◽

10.1007/s00066-020-01670-4 ◽

2020 ◽

Vol 196 (12) ◽

pp. 1103-1115

Author(s):

Maria-Elena A. Salfelder ◽

Kerstin A. Kessel ◽

Uwe Thiel ◽

Stefan Burdach ◽

Severin Kampfer ◽

...

Keyword(s):

Survival Rate ◽

Side Effects ◽

Survival Rates ◽

Young Patients ◽

Intensity Modulated Radiotherapy ◽

High Survival ◽

Single Target ◽

Number Of Patients ◽

Grade 3

Abstract Background and purpose Radiotherapy (RT) is persistently gaining significance in the treatment of pediatric tumors. However, individual features of a growing body and multifocal stages complicate this approach. Tomotherapy offers advantages in the treatment of anatomically complex tumors with low risks of side effects. Here we report on toxicity incidence and outcome of tomotherapy with a focus on multitarget RT (mtRT). Materials and methods From 2008 to 2017, 38 children diagnosed with sarcoma were treated with tomotherapy. The median age was 15 years (6–19 years). Toxicity was graded according to the Common Terminology Criteria for Adverse Events v.4.03 and classified into symptoms during RT, acutely (0–6 months) and late (>6 months) after RT, and long-term sideeffects (>24 months). Results The main histologies were Ewing sarcoma (n = 23 [61%]) and alveolar rhabdomyosarcoma (n = 5 [13%]). RT was performed with a median total dose of 54 Gy (40.5–66.0 Gy) and a single dose of 2 Gy (1.80–2.27 Gy). Twenty patients (53%) received mtRT. Median follow-up was 29.7 months (95% confidence interval 15.3–48.2 months) with a 5-year survival of 55.2% (±9.5%). The 5‑year survival rate of patients with mtRT (n = 20) was 37.1 ± 13.2%, while patients who received single-target RT (n = 18) had a 5-year survival rate of 75 ± 10.8%. Severe toxicities (grade 3 and 4) emerged in 14 patients (70%) with mtRT and 7 patients (39%) with single-target RT. Two non-hematological grade 4 toxicities occurred during RT: one mucositis and one radiodermatitis. After mtRT 5 patients had grade 3 toxicities acute and after single-target RT 4 patients. One patient had acute non-hematological grade 4 toxicities (gastritis, pericarditis, and pericardial effusion) after mtRT. Severe late effects of RT occurred in 2 patients after mtRT and in none of the single-target RT patients. No severe long-term side effects appeared. Conclusion Our results showed acceptable levels of acute and late toxicities, considering the highly advanced diseases and multimodal treatment. Hence, tomotherapy is a feasible treatment method for young patients with anatomically complex tumors or multiple targets. Especially mtRT is a promising and innovative treatment approach for pediatric sarcomas, delivering unexpectedly high survival rates for patients with multifocal Ewing sarcomas in this study, whereby the limited number of patients should invariably be considered in the interpretation.

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Otologic and Audiologic Evaluation of Hearing Loss in Infants

Otolaryngology ◽

10.1016/s0194-5998(05)80226-8 ◽

1995 ◽

Vol 112 (5) ◽

pp. P95-P95

Author(s):

Jane R. Madell ◽

Judith Gravel ◽

Robert J. Ruben

Keyword(s):

Hearing Loss ◽

Infants And Children ◽

Test Results ◽

Impaired Hearing ◽

Educational Objectives ◽

Test Information ◽

Planning Treatment ◽

Audiologic Evaluation

Educational objectives: To select medical and audiologic studies for infants and children with impaired hearing appropriately and to interpret test results and use test information for planning treatment appropriately.

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Aortic and mitral bioprosthetic valve dysfunction: surgical or percutaneous solutions?

European Heart Journal Supplements ◽

10.1093/eurheartj/suab083 ◽

2021 ◽

Vol 23 (Supplement_E) ◽

pp. E6-E12

Author(s):

Igor Belluschi ◽

Nicola Buzzatti ◽

Alessandro Castiglioni ◽

Michele De Bonis ◽

Francesco Maisano ◽

...

Keyword(s):

Heart Valves ◽

Young Patients ◽

Comprehensive Understanding ◽

Valve Dysfunction ◽

Younger Age ◽

Structural Valve Deterioration ◽

Risk Patients ◽

Near Future ◽

Biological Prostheses

Abstract In the last years, there has been a trend to prefer biological prostheses, especially among young patients, with the aim to avoid anticoagulant treatment. Surgical tissue valves have so far demonstrated their solid long-term durability. However, younger age has been identified as one of the main risk factors for developing structural valve deterioration (SVD). As a consequence, the proportion of subjects at risk for valve dysfunction will constantly rise in the near future. However, while surgical reintervention has always been considered the gold standard for treatment of prosthesis deterioration, the introduction of transcatheter heart valves could offer new therapeutical options, particularly among high-risk patients, aiming a second less invasive chance. The recent standardization of valve durability definitions will soon allow a more comprehensive understanding of the mechanism underlying SVD and guide the choice of prosthesis for patients needing valve replacement.

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A Critical Evaluation of Vestibular Schwannoma Surgery for Patients Younger Than 40 Years of Age

Neurosurgery ◽

10.1227/neu.0b013e3181f8d3d3 ◽

2010 ◽

Vol 67 (6) ◽

pp. 1646-1654 ◽

Cited By ~ 10

Author(s):

Michael E Sughrue ◽

Rajwant Kaur ◽

Martin J Rutkowski ◽

Ari J Kane ◽

Isaac Yang ◽

...

Keyword(s):

Hearing Loss ◽

Logistic Regression ◽

Facial Nerve ◽

Surgical Resection ◽

Vestibular Schwannoma ◽

Critical Evaluation ◽

Young Patients ◽

Tumor Control ◽

Multivariate Logistic Regression

Abstract BACKGROUND: There are few published prospective data sets specifically focusing on patients younger than 40 years old undergoing microsurgery for vestibular schwannoma. OBJECTIVE: We describe functional outcomes and long-term tumor control after surgery in patients younger than 40 years old enrolled in a prospectively collected database over a 25-year period. METHODS: We selected all vestibular schwannoma patients from a prospectively collected database who were younger than 40 years old at the time of surgical resection for a vestibular schwannoma. Rates of tumor control and hearing preservation were analyzed using Kaplan-Meier analysis, and risk factors for facial nerve palsy, hearing loss, and trigeminal neuropathy were analyzed using multivariate logistic regression. RESULTS: A total of 204 patients younger than 40 years of age met our inclusion criteria and were included in the analysis. Our data indicate that surgical resection leads to durable long-term freedom from tumor recurrence or progression in 89% of young patients at 15 years of follow-up. Consistent with other published series, hearing was preserved in 68% of patients with smaller tumors (<3 cm). Facial nerve function was preserved in 76% of patients with smaller tumors and 52% of patients with larger tumors (P < .001). On multivariate logistic regression, tumor size was a significant predictor of hearing loss, whereas gross total resection was nearly a significant predictor of hearing loss controlling for other variables (P = .06). CONCLUSION: We present the largest prospectively studied cohort of young patients undergoing microsurgical resection of vestibular schwannoma. These data suggest that surgical resection provides excellent long-term tumor control in these patients.

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Comparison of the subjective hearing loss and pure-tone audiometry test results in long-term follow-up of cases with functional hearing loss

AUDIOLOGY JAPAN ◽

10.4295/audiology.50.180 ◽

2007 ◽

Vol 50 (3) ◽

pp. 180-186 ◽

Cited By ~ 1

Author(s):

Hitoshi Satoh ◽

Toshiyuki Fujisaki ◽

Tadashi Wada ◽

Yamato Kubota ◽

Shuji Izumi ◽

...

Keyword(s):

Hearing Loss ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Test Results ◽

Long Term Follow Up

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The Impact of Subjective and Objective Hearing Loss on Cognition and Memory in Older Adults

Perspectives on Gerontology ◽

10.1044/gero20.2.49 ◽

2015 ◽

Vol 20 (2) ◽

pp. 49-57 ◽

Cited By ~ 1

Author(s):

Yvonne Rogalski ◽

Amy Rominger

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Reading Aloud ◽

Cognitive Testing ◽

Professional Collaboration ◽

Cognitive Screening ◽

Speech Language Pathologist ◽

Text Passage ◽

The Impact ◽

Audiologic Evaluation

For this exploratory cross-disciplinary study, a speech-language pathologist and an audiologist collaborated to investigate the effects of objective and subjective hearing loss on cognition and memory in 11 older adults without hearing loss (OAs), 6 older adults with unaided hearing loss (HLOAs), and 16 young adults (YAs). All participants received cognitive testing and a complete audiologic evaluation including a subjective questionnaire about perceived hearing difficulty. Memory testing involved listening to or reading aloud a text passage then verbally recalling the information. Key findings revealed that objective hearing loss and subjective hearing loss were correlated and both were associated with a cognitive screening test. Potential clinical implications are discussed and include a need for more cross-professional collaboration in assessing older adults with hearing loss.

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Modified Earpieces and CROS for High Frequency Hearing Losses

Journal of Speech and Hearing Research ◽

10.1044/jshr.1101.204 ◽

1968 ◽

Vol 11 (1) ◽

pp. 204-218 ◽

Cited By ~ 9

Author(s):

Elizabeth Dodds ◽

Earl Harford

Keyword(s):

Hearing Loss ◽

Hearing Aids ◽

High Frequency ◽

Hearing Aid ◽

Sound Field ◽

Intensity Level ◽

Test Results ◽

High Frequency Hearing Loss ◽

Increased Sensitivity ◽

Difficult Cases

Persons with a high frequency hearing loss are difficult cases for whom to find suitable amplification. We have experienced some success with this problem in our Hearing Clinics using a specially designed earmold with a hearing aid. Thirty-five cases with high frequency hearing losses were selected from our clinical files for analysis of test results using standard, vented, and open earpieces. A statistical analysis of test results revealed that PB scores in sound field, using an average conversational intensity level (70 dB SPL), were enhanced when utilizing any one of the three earmolds. This result was due undoubtedly to increased sensitivity provided by the hearing aid. Only the open earmold used with a CROS hearing aid resulted in a significant improvement in discrimination when compared with the group’s unaided PB score under earphones or when comparing inter-earmold scores. These findings suggest that the inclusion of the open earmold with a CROS aid in the audiologist’s armamentarium should increase his flexibility in selecting hearing aids for persons with a high frequency hearing loss.

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