What's new in the childhood cancer registry?

Audiological monitoring in Swiss childhood cancer patients

Summary of results

Research questions:

1.     Did childhood cancer patients who received toxic treatment for the ear receive hearing monitoring?

2.     Did patient characteristics or cancer treatment influence hearing monitoring?

3.     Did hearing monitoring improve over the last decade?

Why is this important?

Platinum chemotherapy or cranial radiation can damage hearing. In children, even a mild hearing impairment can impact cognitive and social development. Early detection of hearing loss is essential to allow clinicians to adapt cancer treatment, to counsel patients and parents and to offer hearing aids. These interventions can help to  mitigate the effects of hearing impairment. Existing guidelines recommend hearing monitoring in children with ototoxic treatment, but it is unclear whether clinicians adhere to these recommendations.

What did we do?

In the Swiss Childhood Cancer Registry, we identified all persons diagnosed between 2005-2013 and who had platinum chemotherapy and/or cranial radiation, treatments which are toxic for the ear (also named ototoxic treatment). We searched for their hearing tests in all nine Swiss Pediatric Oncology Centers. We then analyzed in these children how hearing is currently monitored in Switzerland.

What did we find?

We found that less than half of children (43%) had hearing monitoring before, during, and after ototoxic cancer treatment. After treatment, 72% of children were tested. Patients not included in a clinical study were less likely to have had monitoring in all phases of cancer treatment. Patients who received platinum chemotherapy or both platinum chemotherapy and cranial radiation were more likely to have had monitoring after treatment. Monitoring during and after treatment increased in patients treated more recently, whereas monitoring before treatment remained low.

What does this mean?

·         Monitoring guidelines for hearing after childhood cancer were insufficiently followed in Switzerland.

·         Patients who were at high risk to develop hearing loss were more likely to have had their hearing tested, while those not included in a clinical trial were less likely to be tested.

·         This study highlights that we need standardized audiological monitoring in Switzerland.

Additional information:

Weiss et al., Pediatric Blood and Cancer, 2017; doi.org/10.1002/pbc.26877

© ISPM - University of Bern 2019