Cisplatin Ototoxicity in Children: Implications for Primary Care Providers

Jessica Helt-Cameron, MSN, MA, RN; Patricia Jackson Allen, MS, RN, PNP, FAAN

Disclosures

Pediatr Nurs. 2009;35(2):121-127. 

In This Article

Abstract and Introduction

Abstract

This integrative literature review examines the long-term sensorineural hearing loss associated with cisplatin chemotherapy treatment in children with cancer. CINAHL, PsychInfo, Medline, Google Scholar, and Google databases were searched for research related to cisplatin-induced ototoxicity. The characteristics, prevalence, and underlying mechanisms of cisplatin ototoxicity are discussed. Primary care implications, including how and when to monitor the hearing of childhood cancer survivors, ways to provide family support, and education about the significance of hearing losses, and an overview of the management for hearing impairments are presented.

Introduction

The National Cancer Institute (2007) estimates that 12,500 children are diagnosed with cancer each year. Survival rates for childhood cancer have dramatically improved over the past two decades; 80.2% of young children diagnosed before age five, 78.3% of children diagnosed between ages 5 and 9 years, and 70.3% of children diagnosed with cancer during adolescence will survive (American Cancer Society, 2008). This increased survival rate for children with cancer has led to a need for primary care practitioners to become familiar with the long-term effects of cancer and cancer treatment protocols.

Most childhood malignancies are treated with a combination of intense chemotherapy agents, surgery, and/or radiation therapy. Although these treatments are largely successful in putting children’s cancer into remission, they also expose children to related toxicities that may affect children’s normal health and development. This article will review the long-term ototoxic effects of cisplatin, a common chemotherapy agent used to treat many childhood malignancies, ways to screen for auditory toxicity in the primary care setting, and current options for monitoring and managing these children’s sensorineural hearing loss in the primary care setting.

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