Comparison of the Effectiveness of Monitoring Cisplatin-Induced Ototoxicity with Extended High-Frequency Pure-Tone Audiometry or Distortion-Product Otoacoustic Emission

Abstract

Background and ObjectivesTo compare the effectiveness of monitoring cisplatin-induced ototoxicity in adult patients using extended high-frequency pure-tone audiometry (EHF-PTA) or distortion-product otoacoustic emission (DP-OAE) and to evaluate the concurrence of ototoxicity and nephrotoxicity in cisplatin-treated patients.Subjects and MethodsEHF-PTA was measured at frequencies of 0.25, 0.5, 1, 2, 3, 4, 6, 8, 9, 11.2, 12.5, 14, 16, 18, and 20 kHz and DP-OAE at frequencies of 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, and 8 kHz in cisplatin-treated patients (n=10). Baseline evaluations were made immediately before chemotherapy and additional tests were performed before each of six cycles of cisplatin treatment. Laboratory tests to monitor nephrotoxicity were included before every cycle of chemotherapy.ResultsFour of 10 patients showed threshold changes on EHF-PTA. Five of 10 patients showed reductions in DP-OAE, but one was a false-positive result. The results of EHF-PTA and DP-OAE were consistent in two patients. Only one patient displayed nephrotoxicity on laboratory tests after the third cycle.ConclusionsIn our study, the incidence rate of cisplatin-induced ototoxicity was 40% with EHF-PTA or DP-OAE. Although both EHF-PTA and DP-OAE showed the same sensitivity in detecting ototoxicity, they did not produce the same results in all patients. These two hearing tests could be used to complement one another. Clinicians should use both tests simultaneously in every cycle of chemotherapy to ensure the detection of ototoxicity.

Early ototoxic changes in patients with germ cell tumor after first cycle of cisplatin‐based therapy

“…Unfortunately, the number of ototoxic cases was not reported in all studies (69%). The median (mean) of observed ototoxic cases is 63% (57%), a value very similar to that found by us (62%). The criteria used for ototoxicity is not uniform because there is no universally accepted criterion for ototoxic change in DPOAE; nonetheless, several authors of articles from the last 5 years, including our study, used a threshold, particularly one suggested by Beattie et al for the DPOAE amplitude shift.…”

“…With the exception of one article in which the data were not shown, in only three out of 17 articles was the observed shift in DPOAE levels not statistically significant after the first cycle. However, the ototoxicity of cisplatin was demonstrated in further cycles of these investigations . Additionally, in all studies listed in Table , in which DPOAE was measured after second and further cisplatin cycles, the presence of increased hearing impairment was registered.…”

“…Distortion was measured in the right and left ear of patients before (B) and after (A) the first cycle of chemotherapy (1–2 hours after the end of the 5th‐day infusion). Positive differences (B‐A) were considered as significant clinical changes (ototoxic) when greater than 14 dB at 750 Hz and/or greater than 7 dB at higher frequencies …”

Cisplatin-Associated Ototoxicity: A Review for the Health Professional

“…Therefore, using each test in isolation may not be as effective as utilizing a test battery approach, as it increases the chances of obtaining reliable audiologic monitoring data over time. In addition, these two tests could be used to complement one another in every cycle of chemotherapy to ensure the earliest detection of ototoxicity [74]. …”

Does Vincristine affect Cochlear function in children with acute lymphoblastic leukaemia?

“…The damage starts at high-frequency coding cochlear base and progresses towards the apex. 19,20 In our study all children received treatment as per MCP841 protocol which include 12 doses of vincristine at a dose of 1.4 mg/m 2 between baseline and follow up evaluation and cranial irradiation of 1800cGy in those aged above 3 years. Antibiotics were selected at recommended doses depending on the clinical demands.…”