Spence Anne, L'Hotta Allison J, Hayashi Susan S, Felts Kara, LaFentres Emily, Jones-White Megan, Lieu Judith E C, King Allison A, Hayashi Robert J
Department of Pediatrics, Division of Pediatric Hematology Oncology, Washington University in St. Louis, St. Louis, MO, United States.
Brown School, Prevention Research Center, Washington University in St. Louis, St. Louis, MO, United States.
Front Oncol. 2024 Mar 6;14:1362315. doi: 10.3389/fonc.2024.1362315. eCollection 2024.
Childhood cancer survivors (CCS) exposed to platinum chemotherapy are at an increased risk of developing hearing loss and reporting decreased quality of life (QOL). This study compared two QOL measures; one developed for children with hearing loss, The Hearing Environments and Refection on Quality of Life (HEAR-QL), and one validated in CCS, the Patient-Reported Outcomes Measurement Information System (PROMIS), to assess their ability to evaluate QOL deficits in this population.
Subject eligibility were restricted to CCS exposed to platinum-based chemotherapy but who were free of known risk factors for cognitive impairment, (non-central nervous system tumor, no cranial radiation, or intrathecal chemotherapy). Participants had to be between 8-17 years, have completed anti-cancer therapy for at least 6 months, and have an audiogram within 1 year, Participants completed the HEAR-QL-26 (7-12 years) or the HEAR-QL-28 (13-18 years) and the PROMIS. Independent samples and/or one sample T-tests were utilized to compare participants with normal hearing and hearing loss, and to compare outcome measures to normative HEAR-QL and PROMIS data. Non-parametric correlations were utilized to evaluate the relationship between QOL and demographic and medical variables, and QOL and severity of hearing loss.
Fifty-four CCS were evaluable. The mean age was 12.0 years. Twenty-eight participants (51.9%) received cisplatin, 30 (55.6%) carboplatin, and 4 (7.4%) received both. Twenty participants (37%) demonstrated hearing loss. Participants with hearing loss scored significantly lower on the HEAR-QL than those with normal hearing (mean: 70.3, SD: 21.7, vs mean: 88.0, SD: 9.3, p =.004 for the HEAR-QL-26; mean: 84.7, SD: 10.2 vs mean: 94.8, SD: 3.4, p =.040 for the HEAR-QL-28). Participants with normal hearing scored significantly lower on the HEAR-QL-26 than the normative mean (mean: 88, SD: 9.3, normative mean: 98, SD: 5, p =.000). The PROMIS failed to identify any differences in QOL between participants based on hearing status, or when compared to the normative mean.
The HEAR-QL was more sensitive than the PROMIS in identifying QOL deficits in CCS at risk for hearing loss. The HEAR-QL should be considered in studies seeking to improve the QOL of CCS with hearing loss.
接受铂类化疗的儿童癌症幸存者（CCS）出现听力损失及报告生活质量（QOL）下降的风险增加。本研究比较了两种生活质量测量方法；一种是为听力损失儿童开发的《听力环境与生活质量反思》（HEAR-QL），另一种是在CCS中得到验证的患者报告结局测量信息系统（PROMIS），以评估它们评估该人群生活质量缺陷的能力。
受试者入选标准限于接受铂类化疗的CCS，但无已知的认知障碍风险因素（非中枢神经系统肿瘤、无颅脑放疗或鞘内化疗）。参与者年龄须在8至17岁之间，已完成抗癌治疗至少6个月，且在1年内有听力图。参与者完成了HEAR-QL-26（7至12岁）或HEAR-QL-28（13至18岁）以及PROMIS。采用独立样本和/或单样本t检验来比较听力正常和听力损失的参与者，并将结局指标与HEAR-QL和PROMIS的标准数据进行比较。采用非参数相关性分析来评估生活质量与人口统计学和医学变量之间的关系，以及生活质量与听力损失严重程度之间的关系。
54例CCS可进行评估。平均年龄为12.0岁。28名参与者（51.9%）接受顺铂治疗，30名（55.6%）接受卡铂治疗，4名（7.4%）两者均接受。20名参与者（37%）表现出听力损失。听力损失的参与者在HEAR-QL上的得分显著低于听力正常的参与者（HEAR-QL-26的均值：70.3，标准差：21.7，对比均值：88.0，标准差：9.3，p = 0.004；HEAR-QL-28的均值：84.7，标准差：10.2，对比均值：94.8，标准差：3.4，p = 0.040）。听力正常的参与者在HEAR-QL-26上的得分显著低于标准均值（均值：88，标准差：9.3，标准均值：98，标准差：5，p = 0.000）。PROMIS未能识别出基于听力状态的参与者之间或与标准均值相比时生活质量的任何差异。
在识别有听力损失风险的CCS的生活质量缺陷方面，HEAR-QL比PROMIS更敏感。在旨在改善有听力损失的CCS生活质量的研究中应考虑使用HEAR-QL。
