Publications by authors named "Kristin R Knight"
In two randomized trials (Children's Oncology Group ACCL0431 and International Childhood Liver Tumour Strategy Group SIOPEL-6), sodium thiosulfate (STS) demonstrated efficacy in preventing cisplatin-induced hearing loss (CIHL). However, the measures used in those trials have been superseded by the consensus International Society of Paediatric Oncology (SIOP) Ototoxicity Scale. To provide benchmark data for STS efficacy when using this contemporary scale, we reanalyzed ACCL0431 hearing outcomes with the SIOP scale and using multiple timepoints.
View Article and Find Full Text PDFRecommendations for Age-Appropriate Testing, Timing, and Frequency of Audiologic Monitoring During Childhood Cancer Treatment: An International Society of Paediatric Oncology Supportive Care Consensus Report.
JAMA Oncol
October 2021
Article Synopsis
- Ototoxicity is a significant long-term effect of certain cancer treatments in children, making early detection and monitoring of hearing loss crucial for managing their overall care.
- The Ototoxicity Task Force, consisting of experts from various fields, developed standardized recommendations for monitoring hearing loss during pediatric cancer treatment.
- Key findings indicate that children undergoing ototoxic treatments should have regular hearing assessments, including baseline evaluations and ongoing monitoring throughout therapy, to ensure timely interventions when needed.
Article Synopsis
- Cisplatin is widely used to treat various childhood cancers, but it often causes cisplatin-induced hearing loss (CIHL), which can significantly impact young patients' lives.
- A multi-institutional study involving 1481 patients from cancer centers in Canada and the USA examined the prevalence and risk factors of moderate to severe CIHL among children and young adults, finding that 43.8% of participants experienced significant hearing loss.
- The research revealed that the youngest patients and those with specific types of tumors like CNS tumors and hepatoblastoma were at higher risk for CIHL, and higher doses of cisplatin were associated with an increased likelihood of developing hearing loss.
Purpose Optimal assessment methods and criteria for reporting hearing outcomes in children who receive treatment with cisplatin are uncertain. The objectives of our study were to compare different ototoxicity classification systems, to evaluate the feasibility of including otoacoustic emissions and extended high frequency audiometry, and to evaluate a central review mechanism for audiologic results for cisplatin-treated children in the cooperative group setting. Patients and Methods Eligible participants were 1 to 30 years, with planned cisplatin-containing treatment.
View Article and Find Full Text PDFHearing loss (HL) is common in childhood cancer survivors exposed to platinum chemotherapy and/or cranial radiation and can severely impact quality of life. Early detection and appropriate management can mitigate academic, speech, language, social, and psychological morbidity resulting from hearing deficits. This review is targeted as a resource for providers involved in aftercare of childhood cancers.
View Article and Find Full Text PDFArticle Synopsis
- Cisplatin and carboplatin are chemotherapy agents commonly used for treating cancers in both adults and children, but cisplatin leads to significant hearing loss in over 60% of pediatric patients.
- The 42nd Congress of SIOP emphasized the need for collaborative research involving various specialists to find ways to protect hearing during chemotherapy without compromising cancer treatment effectiveness.
- Strategies for otoprotection focus on targeting specific biological pathways and using antioxidant agents, while ensuring careful consideration of treatment timing and international standards for assessing hearing loss are crucial for successful future trials.
Background: The rate of durable responses in embryonal and certain germ cell tumors of the central nervous system (CNS) is unsatisfactory. Intraarterial chemotherapy and osmotic blood-brain barrier disruption (IA/BBBD) increases drug delivery to the CNS.
Methods: Data of patients treated with carboplatin or methotrexate-based IA/BBBD on prospective phase 2 trials conducted at 3 centers were collected.
Purpose: The objective is to describe progressive changes in hearing and cochlear function in children and adolescents treated with platinum-based chemotherapy and to begin preliminary evaluation of the feasibility of extended high-frequency audiometry and distortion product otoacoustic emissions for ototoxicity monitoring in children.
Patients And Methods: Baseline and serial measurement of conventional pure-tone audiometry (0.5 to 8 kHz) and evoked distortion product otoacoustic emissions (DPOAEs) were conducted for 32 patients age 8 months to 20 years who were treated with cisplatin and/or carboplatin chemotherapy.
Purpose: To describe the frequency and severity of ototoxicity in a series of pediatric patients treated with platinum-based chemotherapy.
Patients And Methods: Serial audiologic evaluations were conducted for 67 patients aged 8 months to 23 years who received platinum-based chemotherapy. Audiologic data was analyzed to determine time to hearing-loss using American Speech-Language-Hearing Association (ASHA) criteria, and the effects of treatment and patient characteristics on the incidence and severity of ototoxicity.