Hearing loss due to concurrent daily low-dose cisplatin chemoradiation for locally advanced head and neck cancer.
OBJECTIVE
Cisplatin-based chemo-irradiation (CRT) is increasingly used for head and neck squamous cell carcinoma (HNSCC). We aimed to assess hearing deterioration due to low-dose cisplatin chemoradiation and to compare the observed hearing loss with hearing loss in our previously described high-dose cisplatin CRT cohort.


METHODS
A prospective analysis of hearing thresholds at low and (ultra)-high frequencies obtained before and after treatment in 60 patients. Patients received low-dose cisplatin (6mg/m(2), daily infusions, 20-25 days) with concomitant accelerated radiotherapy (70Gy).


RESULTS
Audiometry up to 16kHz was performed before therapy and 31 days (median) post-treatment. The total incidence of ototoxicity in CTCAEv3.0 was 31% in audiograms up to 8kHz, and 5% of ears tested qualified for HAs due to treatment. The mean hearing loss at speech frequencies was 2.6dB (SD 5.7) and 2.3dB (SD 9.2) at PTA 1-2-4kHz air-conduction and bone-conduction, respectively. The mean hearing loss at ultra-high frequencies (PTA AC 8-10-12.5kHz) was 9.0dB (SD 8.1). Low-dose cisplatin CRT caused less acute hearing loss (CTCAE 31%), compared to high-dose cisplatin CRT (CTCAE 78%).


CONCLUSIONS
Low-dose cisplatin chemo-irradiation for HNSCC is a relatively safe treatment protocol with respect to ototoxicity.
Zuur
Charlotte L
CL
Department of Head and Neck Surgery, VU University Medical Center Amsterdam, Amsterdam, The Netherlands. cl.zuur@vumc.nl
Simis
Yvonne J W
YJ
Verkaik
Roxanna S
RS
Schornagel
Jan H
JH
Balm
Alfons J M
AJ
Dreschler
Wouter A
WA
Rasch
Coen R N
CR
D001299:Audiometry; D002945:Cisplatin / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D034381:Hearing Loss / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects*; D012307:Risk Factors; D018709:Statistics, Nonparametric
D002945:Cisplatin