Treatment-Related Ototoxicity and Reading Impairment in Pediatric Patients With Embryonal Brain Tumors
In a study reported in the Journal of Clinical Oncology, Olivier et al found that pediatric patients with severe sensorineural hearing loss associated with the treatment of embryonal brain tumors experienced greater reading difficulties over time.
The study involved data from 260 children and young adults aged 3 to 21 years (mean = 9.15 years) enrolled in a research and treatment protocol at nine sites in the United States, Australia, and Canada. The protocol included surgery, risk-adapted craniospinal irradiation (average risk = 186, high risk = 74), and chemotherapy. Patients were evaluated at baseline and for up to 5 years for performance on eight neurocognitive variables targeting reading outcomes: sound awareness, phonemic awareness, word attack, letter-word identification, reading fluency, passage comprehension, working memory, and processing speed.
Hearing Loss and Neurocognitive Outcomes
Overall, 196 children had intact hearing or mild to moderate sensorineural hearing loss (Chang grade 0–2a), and 64 had severe sensorineural hearing loss (Chang grade ≥ 2b). Patients with severe sensorineural hearing loss had significantly worse performance than those with normal hearing or mild to moderate sensorineural hearing loss (all P < .05) on all variables except for tasks evaluating awareness of sounds and working memory. In an analysis adjusting for age at diagnosis and risk-adapted craniospinal irradiation dose, performance on phonemic skills, phonetic decoding, reading comprehension, and speed of information-processing remained significantly poorer in children with severe sensorineural hearing loss (all P < .05).
The investigators concluded, “Children with severe sensorineural hearing loss exhibit greater reading difficulties over time. Specifically, they seem to struggle most with phonological skills and processing speed, which affect higher-level skills such as reading comprehension.”
Heather M. Conklin, PhD, of the Department of Psychology, St. Jude Children’s Research Hospital, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the National Cancer Institute and American Lebanese Syrian Associated Charities. For full disclosures of the study authors, visit jco.acopubs.org.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
