Is Methotrexate Ototoxic? Investigating the Ototoxic Late Effects of Pediatric Cancer Treatment.
Brittney Moore, Gabrielle Sheets, Jordan Doss and 7 others
PMID 37532243WHAT IT FOUND
Hearing loss was found in small groups treated with methotrexate without cisplatin or cranial radiation, years after pediatric cancer treatment.
Ask about cancer drugs and make sure audiology follow-up is in place.
Key findings
01Thirty of 66 late effects patients had sensorineural hearing loss.
02Three of eight late effects patients treated with methotrexate without cisplatin or cranial radiation had hearing loss.
03Two of 23 patients currently receiving cancer treatment who were treated with methotrexate had hearing loss.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study looked back at records, so it cannot prove a treatment caused hearing loss. Many patients treated with methotrexate did not have baseline hearing tests, so the timing of hearing loss is unclear. The methotrexate groups were small, including 8 late effects patients treated without cisplatin or cranial radiation and 23 current treatment patients treated with methotrexate. The comparison used a reported 0.1% general population hearing loss rate rather than patients in the study. Patients with pre-existing hearing loss or conditions linked to hearing loss were excluded, so results do not apply to those groups. The two hospital groups were analyzed separately because they were different populations. The study did not find a significant dose dependent effect.
Declared interests
Funding came from National Institutes of Health awards, including the National Cancer Institute and NIH Blueprint for Neuroscience Research. The funding statement also lists NIH support for Z.F.
The easy way to misread this
Do not conclude that methotrexate causes hearing loss. The study is retrospective, many patients lacked baseline hearing tests, and the methotrexate groups were small, so it reports an association rather than proof.