Oh Heonjeong, Park Moo Kyun
Department of Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.
J Audiol Otol. 2025 Apr;29(2):79-85. doi: 10.7874/jao.2025.00073. Epub 2025 Apr 18.
Chemotherapy-induced ototoxicity is a significant concern in pediatric patients with cancer, particularly those treated with platinum-based agents, such as cisplatin and carboplatin. This study reviewed its prevalence, risk factors, early diagnosis, and management strategies. A literature review was conducted to assess the effects of ototoxic chemotherapy, screening methods, and treatment approaches. Various grading scales and rehabilitation strategies were analyzed. Platinum-based chemotherapy causes ototoxic hearing loss in approximately 100% of cases, including high-frequency and delayed-onset losses. Younger age, higher cumulative dose, and cranial irradiation increased the risk. Screening adherence remains suboptimal, despite guidelines recommending early detection through high-frequency audiometry. Sodium thiosulfate may reduce ototoxicity in nonmetastatic cases. If appropriate, hearing aids and cochlear implants can support communication and language development. Ototoxic hearing loss is a prevalent, yet underdiagnosed, complication of pediatric cancer treatment. Standardized screening, otoprotective strategies, and early rehabilitation are essential to minimize their impact on language and quality of life. Greater awareness and national guidelines are required to improve the care of pediatric cancer survivors.
化疗引起的耳毒性是患有癌症的儿科患者的一个重大问题，尤其是那些接受铂类药物（如顺铂和卡铂）治疗的患者。本研究回顾了其患病率、危险因素、早期诊断及管理策略。进行了一项文献综述，以评估耳毒性化疗的影响、筛查方法和治疗方法。分析了各种分级量表和康复策略。铂类化疗在大约100%的病例中会导致耳毒性听力损失，包括高频和迟发性损失。年龄较小、累积剂量较高和颅脑照射会增加风险。尽管有指南建议通过高频听力测定进行早期检测，但筛查依从性仍然欠佳。硫代硫酸钠可能会降低非转移性病例中的耳毒性。如果合适，助听器和人工耳蜗可以支持沟通和语言发展。耳毒性听力损失是儿科癌症治疗中一种普遍但诊断不足的并发症。标准化筛查、耳保护策略和早期康复对于将其对语言和生活质量的影响降至最低至关重要。需要提高认识并制定国家指南，以改善对儿科癌症幸存者的护理。
