Impact of Cisplatin-Induced Hearing Loss on Quality of Life in Childhood Cancer Survivors.

Abstract

Cisplatin-based chemotherapy is essential to treat many childhood cancers but causes irreversible hearing loss (HL). This study examines hearing-related quality of life (HR-QOL) in cisplatin-treated pediatric cancer survivors. This cross-sectional study assessed general and HR-QOL in pediatric cancer survivors using the Pediatric QOL Inventory (PedsQL) and Hearing Environments and Reflection on QOL (HEAR-QL). Audiology assessments were graded with the International Society of Pediatric Oncology (SIOP) Ototoxicity Scale. Communication-impacting HL (CIHL) was defined as SIOP grade ≥2. T-tests or chi-square tests compared QOL end points for patients with versus without CIHL and by dichotomized adherence to hearing aid (HA) use. Hear-QL composite and subcategories were further analyzed using multivariable linear regression. The study enrolled 184 patients (mean age 13 years, 2018-2022) who completed the HEAR-QL survey; 78 (42.2%) of 184 had SIOP grade ≥2 HL. HR-QOL was significantly decreased in patients with CIHL (<i>P</i> = .003 for patients <13 years, <i>P</i> < .001 for those ≥13 years). No impact from CIHL was found for general QOL. In multivariable analysis, CIHL was significantly associated with poorer HR-QOL (patients <13 years; -11.3 points [95% CI, -19.8 to 2.7]; <i>P</i> = .010; patients ≥13 years, -12.3 decrease [95% CI, -19.2 to -5.5]; <i>P</i> = .001). Patients adherent at least sometimes to HA use reported an HR-QOL score <80 across all domains (normative range, 90-100). Survivors with CIHL reported lower HR-QOL that was not captured by general QOL measures. These findings support the critical integration of hearing-specific QOL assessments into survivorship care.