Combination Treatment Reduces Chemotherapy-Induced Hearing Loss in Children

Chemotherapy comes with a laundry list of adverse events, and cisplatin, in particular, frequently causes permanent hearing loss and tinnitus. In a new study published in Lancet Oncology, investigators found that sodium thiosulfate can prevent cisplatin-induced hearing loss in children and adolescents with cancer.

Over a 4-year period, 125 eligible patients with newly-diagnosed cancer, aged 1 to 18 years, were enrolled into the phase 3 ACCL0431 study. Cancer diagnoses were hepatoblastoma, germ cell tumor, medulloblastoma, neuroblastoma, osteosarcoma, and other cancer types, all of which were treated with cisplatin.

The patients were randomized to receive sodium thiosulfate or observation (control) during chemotherapy. Hearing was assessed at baseline, after the chemotherapy regimen was completed, and 1 year later.

The results of the study showed a significant reduction in the incidence of hearing loss in patients treated with cisplatin plus sodium thiosulfate (29%) compared with patients who received cisplatin alone (56%).

Children younger than 5 years, who were most susceptible to, and affected by, cisplatin-induced hearing loss, saw the greatest benefit.

Overall, sodium thiosulfate was well-tolerated with no serious adverse events. Although survival from the cancer was not affected by sodium thiosulfate among participants who had localized tumors, survival did appear to be lower among patients with metastatic disease who received sodium thiosulfate.

“This federally-funded, cooperative group study is the first to show that cisplatin-induced hearing loss can be reduced by about half in children and adolescents being treated for cancer,” said lead study author David R. Freyer, DO, MS. “It is an important step toward developing a safe and effective strategy that will greatly improve quality of life for cancer survivors.”

The authors noted that more research needs to be done to determine what role sodium thiosulfate should have in preventing hearing loss in specific subsets of patients treated with cisplatin.