Abstract
Purpose
Ototoxicity is a prominent side effect of cisplatin-based chemotherapy. There are few reports, however, estimating its prevalence in well-defined cohorts and associated risk factors.
Methods
Testicular cancer (TC) survivors given first-line cisplatin-based chemotherapy completed validated questionnaires. Descriptive statistics evaluated the prevalence of ototoxicity, defined as self-reported hearing loss and/or tinnitus. We compared patients with and without tinnitus or hearing loss using Chi-square test, two-sided Fisher’s exact test, or two-sided Wilcoxon rank sum test. To evaluate ototoxicity risk factors, a backward selection logistic regression procedure was performed.
Results
Of 145 TC survivors, 74% reported ototoxicity: 68% tinnitus; 59% hearing loss; and 52% reported both. TC survivors with tinnitus were more likely to indicate hypercholesterolemia (P = 0.008), and difficulty hearing (P < .001). Tinnitus was also significantly related to age at survey completion (OR = 1.79; P = 0.003) and cumulative cisplatin dose (OR = 5.17; P < 0.001). TC survivors with hearing loss were more likely to report diabetes (P = 0.042), hypertension (P = 0.007), hypercholesterolemia (P < 0.001), and family history of hearing loss (P = 0.044). Risk factors for hearing loss included age at survey completion (OR = 1.57; P = 0.036), hypercholesterolemia (OR = 3.45; P = 0.007), cumulative cisplatin dose (OR = 1.94; P = 0.049), and family history of hearing loss (OR = 2.87; P = 0.071).
Conclusions
Ototoxicity risk factors included age, cisplatin dose, cardiovascular risk factors, and family history of hearing loss. Three of four TC survivors report some type of ototoxicity; thus, follow-up of cisplatin-treated survivors should include routine assessment for ototoxicity with provision of indicated treatments.
Implications for Cancer Survivors
Survivors should be aware of risk factors associated with ototoxicity. Referrals to audiologists before, during, and after cisplatin treatment is recommended.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on request.
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Funding
Drs. Frisina, Dolan, Sesso, Dinh, Feldman, Monahan, and Travis were supported by 2 R01 CA157823 funded by the National Cancer Institute. Dr. Sanchez was supported by R01DC019408-01 funded by the National Institute of Deafness and Other Communication Disorders.
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Conceptualization: LT, RF, VS; methodology: VS, PD, LT, PM, JR; formal analysis and investigation: PM, PD, LT, VS; writing—original draft preparation: VS, JR, LT; writing—review and editing: all authors; funding acquisition: LT; resources: LT; supervision: LT, RF.
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Sanchez, V.A., Dinh, P.C., Rooker, J. et al. Prevalence and risk factors for ototoxicity after cisplatin-based chemotherapy. J Cancer Surviv 17, 27–39 (2023). https://doi.org/10.1007/s11764-022-01313-w
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DOI: https://doi.org/10.1007/s11764-022-01313-w