JAMA Oncol: Relationship between hearing impairment (HI) and neurocognitability in childhood cancer survivors.

Hearing impairment is a serious medical condition, especially if undedited or untreated, and it appears to be associated with an increased risk of neurocognitive impairment.
recently, a cross-sectional study published by American scholars in jama Oncology further analyzed the relationship between hearing sensitivity and task-specific neurocognitive function in the queue of long-term survivors of childhood cancer by treating exposure layering.
, children with cancer have more than 85 percent long-term survival.
despite advances in cancer treatment and supportive care, childhood cancer survivors still face the risk of disease and treatment-related chronic diseases such as hearing impairment (HI) and neurocognitive disorders.
In survivors, patients with malignant tumors receiving central nervous system (CNS) radiation therapy (RT) had the highest risk of neurocognitive dysfunction, and the treatment-induced HI was usually associated with platinum-based chemotherapy or radiation therapy for cochlear implants, and was usually two-sided, permanent, and ongoing.
between HI and neurocognitiability in healthy children has been reported in previous literature, but has only recently been studied among childhood cancer survivors.
Gurney et al. observed that child survivors of neuroblastoma were twice as likely to have difficulty reading, math and/or attention as their parents reported HI and needed more special education services;
specific areas of poor cognition associated with these adverse outcomes were not identified.
a retrospective study of 5,937 adult non-central nervous system survivors, the study showed that HI was associated with reduced task efficiency, tissue, memory, and mood regulation.
however, neurocognit cognitive function and HI are self-reported rather than clinically assessed.
previous studies on the effects of HI on survivors of central nervous system tumors in children treated with platinum chemotherapy and craniofacial RT have shown an independent association between HI and low levels of neurocognitional function.
relationship between HI and neurocognit cognitive function in child cancer survivors who have not received brain radiation therapy has not been reported.
To objectively assess the prevalence, severity, and risk of HI among childhood cancer survivors and to explore the relationship between HI and neurocognit cognitive function, the researchers selected data from eligible survivors who participated in the St. Jude Lifetime Cohort Study (SJLIFE) from April 25, 2007 to June 30, 2017.
cross-sectional study aims to quantify long-term health outcomes for childhood cancer survivors.
participants included children with cancer treated at St. Jude Children's Research Hospital (Memphis, Tennessee), who survived for five years or more after their initial diagnosis and were eligible for hearing and neurocognitor tests.
the hearing results using the Chang ear toxicity grading scale.
data will be analyzed from 22 March 2019 to 5 March 2020.
childhood cancer survivors are exposed according to hearing sensitivity (normal hearing level 0), mild HI (Chang 1a, 1b and 2a level) or severe HI (Chang 2b level)) and treatment The amount (pure platinum exposure group (cisplatin and/or capilated chemotherapy treatment), cochlear RT exposure group (cochlear radiation plus or no platinum chemotherapy treatment), non-exposure group (no platinum chemotherapy or cochlear radiation) were grouped.
multivariable pairs of models were adjusted for age at diagnosis, time since diagnosis, gender, and associated therapeutic exposure.
the study analyzed data on 1,520 childhood cancer survivors, including 814 men (53.6 percent), a mid-age (IQR) age of 29.4 (7.4-64.7) and a mid-term (IQR) diagnosis of 20.4 (6.1-53.8 years).
results showed that survivors in the pure platinum exposure group had a higher risk of developing moderate to severe HI (107 (34.9 percent) and RR was 1.68 (95 percent CI), 1.20 to 2.37, cochlear implant RT exposure group was 181 (38.3 percent), exposure group RR value was 2.69 (95 percent CI 2.02 to 3.57) and unseen group RR value was 65 (8.8 percent).
severe HI is associated with lack of language reasoning ability (unseen group RR, 1.11 (95% CI, 0.50 to 2.43); pure platinum exposure group RR, 1.93 (95% CI, 1.21 to 3.08); cochlea RT exposure group RR, 2.00 (95% CI, 1.46 to 2.75)), language fluency (unsealed group RR, 1.86 (95% CI, 1.19 to 2.91) ); 1.45 (95% CI, 1.09 to 1.94), depending on the speed of motion (unseted group RR, 1.87 (95% CI, 1.07 to 3.25) ; 95% CI, 1.92 to 4.99; Cochlear RT exposure group RR, 1.40 (95% CI, 1.11 to 1.78),) mathematical ability (unseen group RR, 1.90 (95% CI, 1.18 to 3.04; pure platinum exposure group RR, 1.63 (95% CI, 1.05-2.53)); Cochlear implant RT exposure group RR was 1.58 (95% CI, 1.15-2.18) compared to patients with normal hearing or mild HI.
the study showed that severe HI in childhood cancer survivors was associated with neurocognitive impairment, rather than relying on received neurotoxic therapy.
screening and intervention of HIV can promote the development and maintenance of neurocognitional function and identify individuals at risk of injury.
researchers also suggest that early screening and intervention for HI, including adherence to hearing aids and cochlear implants, neuropsychological counseling and educational facilities, may promote the development and maintenance of neurocognitor function and may identify who is at risk of future injury.
therefore, there is a need for further prospective studies on the relationship between hearing aid use and neurocognitive outcomes in children's cancer survivors.
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