title: Evaluation of ototoxicity in patients treated with hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin and sodium thiosulfate.
abstract: OBJECTIVE
  Ototoxic hearing loss associated with intravenous or intra-arterial administration of cisplatin is well documented. However, there is limited data regarding the ototoxic effect of cisplatin when perfused into the abdominal cavity using hyperthermic intraperitoneal chemotherapy (HIPEC). The purpose of this study is to assess and describe ototoxicity in patients treated with HIPEC with cisplatin and sodium thiosulfate for peritoneal surface malignancies.
  
  
  METHODS
  We performed a retrospective chart review (2007-2012) of patients treated for advanced peritoneal malignancies at a tertiary care center using HIPEC with cisplatin and sodium thiosulfate infusion. Thirteen patients (12 males, 1 female) met study criteria. Audiometric thresholds were compared before and after treatment. A 20 dB loss at any single frequency, 10 dB decrease at any two adjacent frequencies, or loss of response at three consecutive test frequencies defined a significant ototoxic change ().
  
  
  RESULTS
  Despite minimal hearing change in six patients, none of the 13 patients in our study exhibited a significant ototoxic change in hearing sensitivity post HIPEC with cisplatin at any test interval in any test frequency.
  
  
  CONCLUSIONS
  Our findings represent the first objective assessment of ototoxic effect after HIPEC with cisplatin and sodium thiosulfate infusion. Our results suggest that peritoneal perfusion of cisplatin with intravenous perfusion of sodium thiosulfate is not associated with ototoxic changes in hearing sensitivity. Further investigation of the administration and systemic mechanism of absorption of sodium thiosulfate as a potential protection against cisplatin ototoxicity is needed to confirm these findings.
authors.affiliation: 1Department of Head and Neck Surgery, and 2Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Allyson M
authors.initials: AM
authors.lastname: Womack
authors.forename: Andrea
authors.initials: A
authors.lastname: Hayes-Jordan
authors.forename: Rajarshi
authors.initials: R
authors.lastname: Pratihar
authors.forename: Denise A
authors.initials: DA
authors.lastname: Barringer
authors.forename: James H
authors.initials: JH
authors.lastname: Hall
authors.forename: Paul W
authors.initials: PW
authors.lastname: Gidley
authors.forename: Jan S
authors.initials: JS
authors.lastname: Lewin
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000975:Antioxidants / Q000009:adverse effects*; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D002648:Child; D002945:Cisplatin / Q000009:adverse effects*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000139:chemically induced*; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D007263:Infusions, Parenteral; D008297:Male; D010534:Peritoneal Neoplasms / Q000628:therapy*; D012189:Retrospective Studies; D013885:Thiosulfates / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D000975:Antioxidants; D013885:Thiosulfates; C017717:sodium thiosulfate; D002945:Cisplatin