Treatment-induced hearing loss and adult social outcomes in survivors of childhood CNS and non-CNS solid tumors: Results from the St. Jude Lifetime Cohort Study.
Treatment-induced hearing loss and adult social outcomes in survivors of childhood CNS and non-CNS solid tumors: Results from the St. Jude Lifetime Cohort Study.
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DOI：
10.1002/cncr.29604
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发表时间：
2015-11-15
期刊：
影响因子：
6.2
通讯作者：
Gurney JG
中科院分区：
文献类型：
--
作者：
Brinkman TM;Bass JK;Li Z;Ness KK;Gajjar A;Pappo AS;Armstrong GT;Merchant TE;Srivastava DK;Robison LL;Hudson MM;Gurney JG
接受铂类化疗和/或颅放射治疗的儿童癌症幸存者有治疗诱导性听力损失的风险;然而，这种听力损失对成人社会成就的影响尚未得到很好的阐明。接受潜在耳毒性癌症治疗的儿童中枢神经系统（CNS; n=180）和非CNS实体瘤（n=226）的成年幸存者完成了听力学评价和评估社会功能感知和社会成就（即独立生活、婚姻、就业）的问卷调查。听力图采用Chang耳毒性分级量表进行分级。按肿瘤类型（即CNS与非CNS）对分析进行分层。多变量逻辑回归模型进行了调整，年龄，性别，慢性健康状况，和中枢神经系统组，智商。报告了调整后的比值比（OR）和95%置信区间（CI）。在36%的CNS和39%的非CNS肿瘤幸存者中检测到严重听力损失（需要助听器或耳聋）。严重听力损失与一个或多个社会功能领域的感知负面影响风险增加相关（非CNS：OR=1.83，95%CI，1.00-3.34）。在非中枢神经系统肿瘤幸存者中，严重听力损失与非独立生活（OR=2.19，95%CI，1.19-4.04）和失业或高中未毕业（OR=1.85，95%CI，1.00-3.34）的风险增加2倍相关。接受潜在耳毒性治疗的儿童癌症成年幸存者中有相当大一部分患有严重的听力损失。在本研究样本中，治疗引起的听力损失与感知和实际的社会成就降低有关。
Survivors of childhood cancer treated with platinum-based chemotherapy and/or cranial radiation are at risk of treatment-induced hearing loss; however, the effects of such hearing loss on adult social attainment have not been well elucidated. Adult survivors of pediatric central nervous system (CNS; n=180) and non-CNS solid tumors (n=226) treated with potentially ototoxic cancer therapy completed audiologic evaluations and questionnaires assessing perception of social functioning and social attainment (i.e. independent living, marriage, employment). Audiograms were graded with the Chang Ototoxicity Grading Scale. Analyses were stratified by tumor type (i.e. CNS vs. non-CNS). Multivariable logistic regression models were conducted with adjustment for age, sex, chronic health conditions, and for the CNS group, IQ. Adjusted odds ratios (OR) and 95% confidence intervals (CI) are reported. Serious hearing loss (requiring a hearing aid or deafness) was detected in 36% of CNS and 39% of non-CNS tumor survivors. Serious hearing loss was associated with increased risk for perceived negative impact in one or more areas of social functioning (non-CNS: OR=1.83, 95% CI, 1.00-3.34). Among non-CNS tumor survivors, serious hearing loss was associated with 2-fold increased risk of non-independent living (OR=2.19, 95% CI, 1.19-4.04) and unemployment or not graduating from high school (OR=1.85, 95% CI, 1.00-3.34). A substantial proportion of adult survivors of childhood cancer treated with potentially ototoxic therapy have serious hearing loss. Treatment-induced hearing loss was associated with reduced social attainment, both perceived and actual, in this study sample.