Early ototoxic changes in patients with germ cell tumor after first cycle of cisplatin-based therapy.
To prospectively examine early hearing damage detectable with distortion product otoacoustic emission (DPOAE) after the first cycle of cisplatin treatment of patients with testicular tumor.



Both ears of 137 consecutive patients were examined at 0.75 to 8 kHz before (B) and after (A) the first cycle of cisplatin (dose: 100 mg/m2/ 5 days).



The mean amplitudes (B vs. A) were compared with paired t test at each frequency. Ototoxic changes were considered when an individual amplitude difference (B-A) > 14 dB at 0.75 Hz or > 7 db at 1 to 8 kHz occurred.



The mean amplitudes were statistically significantly lower after first cycle at 0.75, 6, and 8 kHz. The majority of patients (96%) presented positive differences (B-A) in one or both ears; in 85 (62%) cases, the positive difference reached the level of ototoxicity out of which 34 (40%) and 19 (22%) of patients suffered ototoxicity in one or both ears, respectively. The difference between right and left ears in distribution of ototoxic cases was nonsignificant. Forty-five (33%) and four (3%) patients showed ototoxicity at two or more frequencies in one or both ears, respectively. An increased proportion of ototoxic cases can be seen at 0.75 to 1 kHz and 6 to 8 kHz.



After the first cycle of cisplatin treatment, early ototoxicity occurs in close to two-thirds of patients, as identified by measuring DPOAE. Therefore, further research for biomarkers is required, which can predict patients at risk in order to avoid an irreversible hearing loss by personalized, preventive therapies.



4. Laryngoscope, 127:1909-1915, 2017.
Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary.
László
L
Noszek
Department of Molecular Immunology and Toxicology, National Institute of Oncology, Budapest, Hungary.
Barna
B
Budai
Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary.
Péter
P
Prekopp
Department of Pediatrics, Petz Aladár Hospital, Győr, Hungary.
Renáta
R
Széchenyi
Department of Oncology, Szent Margit Hospital, Budapest, Hungary.
Márta
M
Szőnyi
Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary.
Szabolcs
S
Talpai
Department of Medical Oncology and Clinical Pharmacology "C", National Institute of Oncology, Budapest, Hungary.
Krisztián
K
Nagyiványi
Department of Medical Oncology and Clinical Pharmacology "C", National Institute of Oncology, Budapest, Hungary.
Krisztina
K
Bíró
Department of Medical Oncology and Clinical Pharmacology "C", National Institute of Oncology, Budapest, Hungary.
Lajos
L
Géczi
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects*; D034381:Hearing Loss / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy*; D011446:Prospective Studies; D013736:Testicular Neoplasms / Q000188:drug therapy*; D013997:Time Factors; D055815:Young Adult
D000970:Antineoplastic Agents; D002945:Cisplatin
Ototoxicity; cisplatin; distortion product otoacoustic emission (DPOAE); testicular cancer