儿童肿瘤患者接受铂类化疗后的听力学结局

文献信息

中文摘要

目的： 本研究旨在回顾性评估接受铂类化疗的儿童肿瘤患者中耳毒性发展的听力学监测。
方法： 这项回顾性研究纳入了2015年至2023年间在儿科血液/肿瘤门诊接受铂类化疗且具有治疗前和治疗后听力学评估的14例年龄1个月至18岁的患者。听力学评估在250至6000 Hz频率范围内进行，听力损失根据美国言语-语言-听力协会标准进行分类。
结果： 治疗后观察到听阈普遍升高，其幅度因频率而异。虽然在低频和中频检测到显著变化，但在高频（4000至6000 Hz）观察到最明显的升高，且在这些频率上效应量较大。在高频听力损失的评估中，85.7%的患者存在听力损失。比较低频和高频时，高频的听阈升高显著更大。在右耳与左耳的比较中，观察到左耳听力损失更严重的趋势；然而，这一差异无统计学意义。
结论： 铂类化疗可能与儿童肿瘤患者临床上相关的听阈偏移有关，尤其是在高频。定期听力学监测对于早期识别和管理听力损失非常重要。

英文摘要

PURPOSE: This study aimed to retrospectively evaluate the audiological monitoring of ototoxicity developing in pediatric oncology patients receiving platinum-based chemotherapy.
METHODS: This retrospective study included 14 patients aged 1 month to 18 years who received platinum-based chemotherapy at the pediatric hematology/oncology clinic between 2015 and 2023 and had pre- and post-treatment audiometric evaluations. Audiometric evaluations were performed in the 250 to 6000 Hz frequency range, and hearing loss was classified according to American Speech-Language-Hearing Association criteria.
RESULTS: A general increase in hearing thresholds was observed post-treatment, with the magnitude varying by frequency. While significant changes were detected in low and midfrequencies, the most pronounced increase was observed in high frequencies (4000 to 6000 Hz), and the effect size was large at these frequencies. In the assessment of high-frequency hearing loss, 85.7% of patients had hearing loss. When comparing low and high frequencies, the increase in hearing thresholds was significantly greater at high frequencies. In comparisons between the right and left ears, a tendency toward greater hearing loss was observed in the left ear; however, this difference was not statistically significant.
CONCLUSION: Platinum-based chemotherapy may be associated with clinically relevant hearing threshold shifts in pediatric oncology patients, particularly at high frequencies. Regular audiological monitoring is important for the early identification and management of hearing loss.