Evaluation of amifostine for protection against cisplatin-induced serious hearing loss in children treated for average-risk or high-risk medulloblastoma

James G. Gurney, Johnnie K. Bass, Arzu Onar-Thomas, Jie Huang, Murali Chintagumpala, Eric Bouffet, Tim Hassall, Sridharan Gururangan, John A. Heath, Stewart Kellie, Richard Cohn, Michael J. Fisher, Atmaram Pai Panandiker, Thomas E. Merchant, Ashok Srinivasan, Cynthia Wetmore, Ibrahim Qaddoumi, Clinton F. Stewart, Gregory T. Armstrong, Alberto BroniscerAmar Gajjar

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Background The purpose of this study was to evaluate amifostine for protection from cisplatin-induced serious hearing loss in patients with average-risk medulloblastoma by extending a previous analysis to a much larger sample size. In addition, this study aimed to assess amifostine with serious hearing loss in patients with high-risk medulloblastoma treated with cisplatin. Methods Newly diagnosed medulloblastoma patients (n = 379; ages 3-21 years), enrolled on one of 2 sequential St. Jude clinical protocols that included 4 courses of 75 mg/m2 cisplatin, were compared for hearing loss by whether or not they received 600 mg/m2 of amifostine immediately before and 3 hours into each cisplatin infusion. Amifostine administration was not randomized. The last audiological evaluation between 5.5 and 24.5 months following protocol treatment initiation was graded using the Chang Ototoxicity Scale. A grade of ≥2b (loss requiring a hearing aid or deafness) was considered a serious event. Results Among average-risk patients (n = 263), amifostine was associated with protection from serious hearing loss (adjusted OR, 0.30; 95% CI, 0.14-0.64). For high-risk patients (n = 116), however, there was not sufficient evidence to conclude that amifostine prevented serious hearing loss (OR, 0.89; 95% CI, 0.31-2.54). Conclusions Although patients in this study were not randomly assigned to amifostine treatment, we found evidence in favor of amifostine administration for protection against cisplatin-induced serious hearing loss in average-risk but not in high-risk, medulloblastoma patients.

Original languageEnglish (US)
Pages (from-to)848-855
Number of pages8
JournalNeuro-oncology
Volume16
Issue number6
DOIs
StatePublished - Jun 2014

Keywords

  • audiology
  • brain neoplasms
  • late effects
  • ototoxicity
  • platinum drugs

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Clinical Neurology

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