Assessment and Management of Platinum-Related Ototoxicity in Children Treated for Cancer

Platinum compounds are a group of chemotherapeutic agents included in many pediatric\r\nand adult oncologic treatment protocols. The main platinum compounds are cisplatin, carboplatin,\r\nand oxaliplatin. Their use in clinical practice has greatly improved long-term survival of pediatric\r\npatients, but they also cause some toxic effects: ototoxicity, myelosuppression, nephrotoxicity, and\r\nneurotoxicity. Hearing damage is one of the main toxic effects of platinum compounds, and it\r\nderives from the degeneration of hair cells of the ear, which, not having self-renewal capacity, cannot\r\nreconstitute themselves. Hearing loss from platinum exposure is typically bilateral, sensorineural,\r\nand permanent, and it is caused by the same mechanisms with which platinum acts on neoplastic\r\ncells. According to available data from the literature, the optimal timing for the audiological test\r\nduring and after treatment with platinum compounds is not well defined. Moreover, no substances\r\ncapable of preventing the onset of hearing loss have been identified.