RADIOTHERAPY ENHANCED OTOTOXICITY OF CISPLATIN IN CHILDREN

We reviewed and re-examined 31 children (6 months-14 years at the time of diagnosis), who had been treated for a neoplasm in Turku Universit y Central Hospital between 1989 and 1994. The children were divided in to 3 groups according to the site of the neoplasm and the type of ther apy. Group I included 13 children, operated on for an intracranial tum or and received postoperative radio-and cisplatin-based chemotherapy. Group II included 14 children operated on for intracranial tumors and treated with radiotherapy, but not given chemotherapy. Group III inclu ded 4 children suffering from extracranial malignancies and they had r eceived chemotherapy including cisplatin. The children in Group I had significantly worse hearing thresholds in the middle-and high-frequenc y range than children in Groups II and III. In a precise analysis of t he different factors, no single dose of cisplatin, inner ear irradiati on dose or totally to the central nervous system (CNS) received irradi ation dose correlated to the detected hearing loss. However, multiple linear correlation analyses suggest a combined effect of radiotherapy plus cisplatin resulting in a high frequency hearing loss. This is in accordance with earlier random case reports, and supports the idea tha t radiotherapy should be considered cautiously in children treated wit h cisplatin for intracranial malignancies.