By Lynda Williams, medwireNews Reporter
medwireNews: Childhood cancer survivors (CCSs) with severe to profound sensorineural hearing loss (SNHL) following chemotherapy or radiotherapy may be candidates for cochlear implants, US researchers believe.
“With advancements in technology and candidacy criteria, cochlear implants are now safe and viable for many CCSs”, says the team.
The investigators found that 61.1% of 376 patients with SNHL who had survived for at least 5 years after their cancer diagnosis at St Jude’s Children’s Research Hospital in Memphis, Tennessee, USA, met the criteria for cochlear implants, defined as a 60 dB or higher pure tone average at 1000, 2000, 3000 or 4000 Hz, or a word recognition score of 60% or lower in either ear.
The patients (59.8% boys) were aged a median 5.74 years at the time of cancer diagnosis and a median 28.73 years at the time of audiological assessment.
Multivariable logistic regression analysis identified key characteristics that were significantly associated with the likelihood of cochlear implant eligibility, report Johnnie Bass (St Jude Children’s Research Hospital) and co-authors in JAMA Oncology.
As expected, this included increasing cumulative cisplatin dose (odds ratio [OR]=1.30 per 100 mg/m2) and increasing cochlear radiation dose (OR=1.03 per Gy). In addition, CCSs were significantly more likely to be candidates for a cochlear implant if they had a non-central nervous system malignancy (OR=1.99).
By contrast, the likelihood of eligibility was not significantly predicted by sex, race/ethnicity, age at cancer diagnosis or audiological assessment, or carboplatin or aminoglycoside dosage.
The researchers note that just 41.7% of the 218 CCSs who were eligible for cochlear implants used a hearing aid, perhaps because they are perceived as having “little to no” benefit.
“Earlier [cochlear implant candidacy evaluation] referral may help address low hearing aid uptake and lead to more appropriate interventions, particularly in CCSs with minimal hearing aid benefit”, Bass et al write.
“In this population, while cochlear implant outcomes are sparse yet promising, cochlear implants present unique challenges that should be considered before pursuing SNHL treatment.”
The team concludes that “[l]arger, prospective studies investigating cochlear implant outcomes in CCSs are needed.”
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JAMA Oncol 2025; doi:10.1001/jamaoncol.2025.0856