Audiometric patterns in ototoxicity of intra-arterial Cisplatin chemoradiation in patients with locally advanced head and neck cancer.
This study describes audiometric patterns of ototoxicity in a consecutive series of patients uniformly treated with intra-arterial high-dose cisplatin chemoirradiation for advanced cancer of the head and neck. Air conduction thresholds were measured from 0.125 to 16 kHz and bone conduction thresholds were measured from 0.5 to 4 kHz. The overall audiometric pattern was characterized by maximum threshold shifts after the 2nd cisplatin infusion and a maximum total threshold shift at 8 kHz, irrespective of gender, age, pretreatment sensorineural hearing loss (SNHL) or subjective complaints during therapy. A hearing deterioration gradient was observed from (ultra-) high to low frequencies, worse with increasing pre-existent SNHL and with increasing cumulative dose of cisplatin chemoradiation. Cisplatin chemoradiation-induced hearing loss seemed to reach a plateau at higher levels (75-80 dB HL) for frequencies above 8 kHz compared to frequencies up to 8 kHz (45-60 dB HL). Recovery of SNHL was found after therapy in 27 ears characterized by extensive hearing loss at frequencies 1, 2 and 4 kHz.
Zuur
C L
CL
Department of Otorhinolaryngology, Academical Medical Centre Amsterdam, Amsterdam, The Netherlands. cl.zuur@vumc.nl
Simis
Y J W
YJ
Lansdaal
P E M
PE
Rasch
C R N
CR
Tange
R A
RA
Balm
A J M
AJ
Dreschler
W A
WA
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000187:drug effects* / Q000528:radiation effects; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D006319:Hearing Loss, Sensorineural / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018714:Radiotherapy, Adjuvant
D000970:Antineoplastic Agents; D002945:Cisplatin