title: High prevalence of cisplatin-induced ototoxicity in Cape Town, South Africa.
abstract: BACKGROUND
  Cisplatin is administered as the first-line treatment of soft-tissue cancers. It has a reported cure rate of up to 85%, but is associated with a high incidence of ototoxicity, characterised by irreversible bilateral hearing loss and affecting 23 - 50% of adults who receive the drug.
  
  
  OBJECTIVE
  To determine the incidence of cisplatin-induced ototoxicity at Groote Schuur Hospital (GSH), Cape Town, South Africa.
  
  
  METHODS
  retrospective cross-sectional study of cisplatin-receiving cancer patients attending GSH between January 2006 and August 2011.
  
  
  RESULTS
  A total of 377 patients were recorded as receiving cisplatin therapy during the study period. A 300% increase in new cisplatin-receiving patients receiving audiological monitoring was observed between 2006 and 2010. However, only patients with all clinical data as well as baseline and follow-up audiometric analyses were investigated. One hundred and seven such patients were identified, 55.1% of whom developed cisplatin-induced ototoxicity while receiving high-dose (> or = 60 mg/m2) cisplatin treatment. Higher cumulative cisplatin dosages were associated with development of significant hearing loss (p = 0.027). The odds of developing cisplatin-induced hearing loss were elevated for patients with head and neck tumours and lymphoma (p = 0.0465 and p = 0.0563, respectively) and were significantly lower for those with reproductive cancers (p = 0.0371).
  
  
  CONCLUSIONS
  Comprehensive audiological monitoring should be available for every patient during cisplatin treatment to minimise the development of disabling hearing loss.
authors.forename: H
authors.initials: H
authors.lastname: Whitehorn
authors.forename: M
authors.initials: M
authors.lastname: Sibanda
authors.forename: M
authors.initials: M
authors.lastname: Lacerda
authors.forename: T
authors.initials: T
authors.lastname: Spracklen
authors.forename: L
authors.initials: L
authors.lastname: Ramma
authors.forename: S
authors.initials: S
authors.lastname: Dalvie
authors.forename: R
authors.initials: R
authors.lastname: Ramesar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001301:Audiometry, Pure-Tone; D002945:Cisplatin / Q000009:adverse effects*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy; D006258:Head and Neck Neoplasms / Q000188:drug therapy; D006312:Hearing Loss, Bilateral / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008223:Lymphoma / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin