title: Decreased hearing after combined modality therapy for head and neck cancer.
abstract: OBJECTIVE
  Combined platinum-based chemoradiation therapy is frequently being used as therapy for head and neck cancer at multiple sites. These therapies are individually ototoxic, but little has been reported on their combined toxicity.
  
  
  METHODS
  A retrospective investigation of 37 patients known to have undergone therapy with both agents, in combination, for head and neck malignancy was performed. Sixty percent of the patients had complaints of hearing loss subjectively. Reliable pretreatment and posttreatment audiograms were obtained on 15 of these patients. Audiograms were analyzed for sensorineural changes at 0.5, 1, 2, 4, and 8 kHz.
  
  
  RESULTS
  By paired t test analysis, there were significant changes in the patients with pretreatment and posttreatment audiograms at all frequencies. More than 50% of the patients had a change of 10 dB or greater in their pure-tone average. More than 85% of the patients experienced changes in their hearing at 4 and 8 kHz.
  
  
  CONCLUSIONS
  We conclude that patients undergoing combined modality therapy for head and neck cancer experience hearing loss. We recommend that hearing assessment, including pretreatment and posttreatment audiometry, be performed in all patients undergoing combined platinum-based chemotherapy and radiation for the treatment of head and neck cancer.
authors.affiliation: Department of Otolaryngology, University of Minnesota, SE, Box 396, Minneapolis, MN 55425, USA.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Pearson
authors.forename: Abby C
authors.initials: AC
authors.lastname: Meyer
authors.forename: George L
authors.initials: GL
authors.lastname: Adams
authors.forename: Frank G
authors.initials: FG
authors.lastname: Ondrey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001299:Audiometry; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006319:Hearing Loss, Sensorineural / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin