Report on hearing loss in oncology

Schultz, Christiane; Goffi-Gómez, María Valéria Schmidt; Liberman, Patrícia Helena Pecora; Carvalho, André Lopes

doi:10.1590/s1808-86942009000500004

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…Therefore, the Health Professions Council of South Africa (HPCSA) [34] recommends the sequential use of ASHA [22] criteria and then the NCI-CTCAE grading scale [30] to grade the severity of the ototoxic change which relates to the functional impact on the patient's quality of life. The percentage of significant ototoxic change in the current study, being higher than previously reported in South Africa [35], and other international studies [36][37][38][39][40][41][42], may be attributed to the use of extended high-frequency audiometry in the current study. However, there is still a higher percentage of ototoxic change in the current study compared to other studies that also utilized extended high-frequency audiometry [9,40], which could be due to differences in the study population, such as the high incidence of HIV and the use of ARTs.…”

Section: Discussioncontrasting

confidence: 73%

Cisplatin-associated ototoxicity amongst cervical cancer patients: A prospective cohort study in south Africa

et al. 2023

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Background Concurrent chemoradiotherapy using weekly cisplatin remains standard of care for locally advanced cervical cancer in Sub-Saharan Africa. While cisplatin remains a popular cancer chemotherapeutic, it has an irreversible ototoxic effect on patients’ auditory system. However, there is a paucity of epidemiological information on its extent and severity during cervical cancer treatment. In a region with a high burden of cervical cancer, this has serious consequences for aural intervention and rehabilitation. Methods and findings Using a prospective cohort study design, 82 patients with incident cervical cancer, receiving weekly cisplatin chemotherapy (50 mg/m2 body surface) at a tertiary level hospital in KwaZulu-Natal Province of South Africa, underwent audiological assessments at various intervals. We describe the temporal impact of cisplatin exposure on hearing loss, its combined effect with HIV-infection, and estimate ototoxicity incidence in this cohort. The median age was 52 years with Stages IIB (45%) and IIIB (35.4%) cancers being most common. Complaints of reduced hearing sensitivity increased significantly (p<0.0001). Bilateral, asymmetrical sensorineural hearing loss, with greater effect in the extended high-frequency range, was evident. Cisplatin dosage was significantly associated with ototoxicity severity at one- (p = 0.017), three- (p = 0.010), and six-month (p = 0.015) post-treatment follow-up. HIV-seropositivity (53.7%) was significantly associated with NCI-CTCAE Grading Scale at three- (p = 0.022) and six-months (p = 0.023) post-treatment. Multiple Tobit regression revealed a cumulative dose effect bilaterally, after adjustment for age and HIV status, evident from 9000Hz and above in the right ear, while a plateau effect was observed at 250mg/m2 in the left ear. The incidence was ototoxicity was 98% at a cumulative dose of 150mg/m2. Conclusion The findings of this epidemiologic study highlight the temporal course and severity of ototoxicity experienced by cervical cancer patients treated with cisplatin, with greater impact in HIV-positive subgroup, thus underscores the need for audiological monitoring and timely interventions in this cohort.

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Section: Discussioncontrasting

confidence: 73%

Cisplatin-associated ototoxicity amongst cervical cancer patients: A prospective cohort study in south Africa

et al. 2023

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“…Importantly, in our experience, the average age of Veterans entering treatment is 60 yr and most report a history of significant noise exposure [4][5], which accounts for the high rate of preexisting hearing loss in this population. It is well documented that hearing loss adversely impacts quality of life [6]; psychosocial functioning [7]; and one's ability to obtain, process, and understand basic health information [8]; therefore, it is an undeniably important side effect to monitor during chemotherapy. Furthermore, health-related quality of life concerns are important to oncologists because improved treatments and early diagnoses have increased long-term cancer survivability.…”

Section: Introductionmentioning

confidence: 99%

Proposed comprehensive ototoxicity monitoring program for VA healthcare (COMP-VA)

Konrad-Martin¹,

Reavis²,

McMillan³

et al. 2014

J Rehabil Res Dev

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Abstract-Prevention and rehabilitation of hearing loss and tinnitus, the two most commonly awarded service-connected disabilities, are high priority initiatives in the Department of Veterans Affairs (VA). At least 4,000 Veterans, most with significant hearing loss, will receive cisplatin this year, with more than half sustaining permanent hearing shift and nearly 40% developing new tinnitus. With improved survivability following cancer treatment, Veterans treated with cisplatin are approached with the dual goals of effective treatment and preserved quality of life. This article describes COMP-VA, a comprehensive ototoxicity monitoring program developed for VA patients receiving cisplatin. The program includes an individualized pretreatment prediction model that identifies the likelihood of hearing shift given cisplatin dose and patient factors. It supports both manual and automated hearing testing with a newly developed portable audiometer capable of performing the recommended procedures on the chemotherapy unit during treatment. It also includes objective methods for identifying outer hair cell changes and predicting audiogram changes using distortion-product otoacoustic emissions. We describe this program of evidence-based ototoxicity monitoring protocols using a case example to give the reader an understanding of how this program would be applied, along with a plan for future work to accomplish the final stages of program development.

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“…Other studies with a prospective enrollment of cancer patients following strict audiological workup protocols corroborate this hypothesis. Those studies reported a much higher ototoxicity occurrence, reaching up to 64%, depending on the hearing loss criteria (Helson et al, 1978;Aguilar-Markulis et al, 1981;Reddel et al, 1982;Schultz et al, 2009). Furthermore, centers performing additional extended high-frequency audiometry (up to 20 kHz) reported a higher occurrence of cisplatin ototoxicity than centers with the standard audiometric testing (up to 8 kHz), as used in the present study (Zuur et al, 2008;Arora et al, 2009).…”

Section: Limitations and Strengthsmentioning

confidence: 50%

Incidence of cisplatin-induced ototoxicity in adult cancer patients based on audiometric confirmation of patient self-report

Voruz,

Vuilleumier,

Migliorini

et al. 2023

Front. Audiol. Otol.

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IntroductionRobust clinically relevant epidemiological and audiological data are needed to prepare for future clinical trials aiming at preventing cisplatin-induced ototoxicity in this suffering cancer population. We assessed the incidence, severity, and potential risk factors of symptomatic cisplatin-induced hearing loss in a large cohort of adults.MethodsRetrospective cohort study at a tertiary care university hospital. The study group included consecutive patients over 18 years old treated with cisplatin-based chemotherapy without concomitant inner ear radiotherapy or other ototoxic medication. Every participant underwent baseline pretreatment audiometry and was asked for audiological symptoms (tinnitus or subjective hearing loss) during the treatment. If symptomatic, comparative standard audiometry (0.125 to 8 kHz) was performed. Hearing loss was defined by a threshold shift ≥15 dB HL in at least one of the tested frequencies.ResultsA total of 401 cancer patients (59% males) with a mean age of 56 years (range 18-80) were included. Eighty-one patients (20%) developed symptomatic hearing loss, predominantly affecting the high frequencies from 4 to 8 kHz. Among them, 49 (60%) experienced simultaneous new-onset tinnitus. None of the analyzed potential risk factors (age, sex, smoking, hypertension, diabetes, dyslipidemia, chemotherapeutic regimen, and cumulative cisplatin dose) was statistically correlated with hearing loss.DiscussionAt least 1 out of 5 patients treated with cisplatin developed audiological symptoms associated with audiometric hearing loss within the 0.125 to 8 kHz range, for which new-onset tinnitus is a sensitive symptom. Not all audiological symptoms are accompanied by audiometric change. No predisposing factor could be identified. Standardized audiological monitoring before and during cisplatin-based chemotherapy allows quantitative assessment of early audiometric signs of ototoxicity, offering to optimize anticancer therapy while minimizing morbidity in a multidisciplinary setting.

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Report on hearing loss in oncology

Cited by 5 publications

References 19 publications

Cisplatin-associated ototoxicity amongst cervical cancer patients: A prospective cohort study in south Africa

Cisplatin-associated ototoxicity amongst cervical cancer patients: A prospective cohort study in south Africa

Proposed comprehensive ototoxicity monitoring program for VA healthcare (COMP-VA)

Incidence of cisplatin-induced ototoxicity in adult cancer patients based on audiometric confirmation of patient self-report

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