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

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

Research output: Contribution to journalArticle

17 Citations (Scopus)

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 (f 2=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 f 2=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 (US)
Pages (from-to)1156-1163
Number of pages8
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume74
Issue number10
DOIs
StatePublished - Oct 1 2010

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Retinoblastoma
Carboplatin
Drug Therapy
Outer Auditory Hair Cells
Ear
Retina
Neoplasms
Pediatrics

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology
  • Pediatrics, Perinatology, and Child Health

Cite this

Monitoring carboplatin ototoxicity with distortion-product otoacoustic emissions in children with retinoblastoma. / Bhagat, Shaum P.; Bass, Johnnie K.; White, Stephanie T.; Qaddoumi, Ibrahim; Wilson, Matthew; Wu, Jianrong; Rodriguez-Galindo, Carlos.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 74, No. 10, 01.10.2010, p. 1156-1163.

Research output: Contribution to journalArticle

Bhagat, Shaum P. ; Bass, Johnnie K. ; White, Stephanie T. ; Qaddoumi, Ibrahim ; Wilson, Matthew ; Wu, Jianrong ; Rodriguez-Galindo, Carlos. / Monitoring carboplatin ototoxicity with distortion-product otoacoustic emissions in children with retinoblastoma. In: International Journal of Pediatric Otorhinolaryngology. 2010 ; Vol. 74, No. 10. pp. 1156-1163.
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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 (f 2=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 f 2=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.",
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AU - Bhagat, Shaum P.

AU - Bass, Johnnie K.

AU - White, Stephanie T.

AU - Qaddoumi, Ibrahim

AU - Wilson, Matthew

AU - Wu, Jianrong

AU - Rodriguez-Galindo, Carlos

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N2 - 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 (f 2=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 f 2=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.

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