Comparison of Scales for Assessing Cisplatin-Related Ototoxicity in Children
In a study reported in the Journal of Clinical Oncology, Knight et al of the Children’s Oncology Group found that the Society for Industrial and Organizational Psychology Ototoxicity (SIOP) scale may be more sensitive than other classification systems in detecting ototoxicity in children receiving cisplatin for cancer treatment.
Study Details
The study included 284 patients with a median age of 10.2 years (range = 0.1–21.3 years) with planned cisplatin-containing treatment. Hearing was assessed at baseline, before each cisplatin cycle, and at the end of therapy using the SIOP scale, the American Speech-Language-Hearing (ASHA) Association Ototoxicity Criteria, the Common Terminology Criteria for Adverse Events (CTCAE) version 3.0, and the Brock Ototoxicity Grades (Brock).
Key Findings
Any degree of ototoxicity was present in 40% to 56% of patients at the end of treatment, with severe ototoxicity identified in 7% to 22%. On central review, compared with CTCAE (51%), the SIOP scale (55%, P = .004) and the ASHA criteria (56%, P = .0002) detected significantly more ototoxicity of any severity, with Brock criteria detecting significantly fewer cases (40%, P <.001). For severe toxicity at the end of therapy, compared with CTCAE (18%), the SIOP scale detected more cases (22%, P = .02) and the Brock criteria detected fewer cases (7%, P <.001).
The SIOP scale detected ototoxicity earlier than the other scales, followed in order by the ASHA criteria, CTCAE, and the Brock criteria. Agreement between central reviewers and an institutional audiologist was nearly perfect for the ASHA and Brock critiera, with the poorest agreement observed for CTCAE.
The investigators concluded: “The SIOP scale may be superior to ASHA, Brock, and CTCAE scales for classifying ototoxicity in pediatric patients who were treated with cisplatin. Future studies should evaluate inter-rater reliability of the SIOP scale.”
The study was supported by a Community Clinical Oncology Program research base grant, an National Cancer Institute Community Oncology Research Program research base grant, and a National Clinical Trials Network Statistics and Data Center award.
Kristin R. Knight, MD, of Oregon Health and Science University, is the corresponding author of the Journal of Clinical Oncology article.
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