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Trends in ototoxicity monitoring among cisplatin-treated patients with cancer

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Abstract

Purpose

This study aims to characterize patterns in ototoxicity monitoring and identify potential barriers to audiologic follow-up.

Methods

We performed a single-institution retrospective cohort study on adult (≥ 18 years old) cancer patients treated with cisplatin from January 2014 to September 2021. Our primary outcomes were rates of baseline and post-treatment audiograms at the following time points: 3, 6, 12, and greater than 12 months. Time-to-event analyses were performed to describe additional insights to ototoxicity monitoring patterns.

Results

Nine hundred fifty-five patients with cancer were included for analysis. The most common primary cancer sites were head and neck (64%), followed by cervical (24%). Three hundred seventy-three patients (39%) underwent baseline audiometric assessment, 38 patients (4%) received audiologic evaluation during chemotherapy, and 346 patients (36%) obtained at least one post-treatment audiogram. Audiologic follow-up was greatest within 3 months of completing chemotherapy (26%), but this tapered dramatically to less than 10% at every other post-treatment time point. Patients with head and neck cancer achieved higher rates of audiologic follow-up at every time point than patients with non–head and neck cancer except for during treatment.

Conclusions

Ototoxicity monitoring is an inconsistent practice, particularly during chemotherapy and for long-term surveillance of hearing loss. Patients with non–head and neck cancer may be at increased risk for loss of audiologic follow-up.

Implications for Cancer Survivors

Cisplatin ototoxicity is a common occurrence that can be effectively managed with auditory rehabilitation. Therefore, referrals to audiology and counseling on treatment-related ototoxicity are recommended throughout chemotherapy and cancer survivorship.

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Data availability

No datasets were generated or analyzed during the current study.

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Funding

Research reported in this publication was supported by the National Institute of Deafness and Other Communication Disorders (NIDCD) within the National Institutes of Health (NIH), through the “Development of Clinician/Researchers in Academic ENT” training grant, award number T32DC000022 and R25DC020706.

Author information

Authors and Affiliations

  1. Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus, Box 8115, St. Louis, MO, 63110, USA

    David S. Lee, Marie-Ange Munyemana, Lauren Mueller, Jason T. Rich, Patrik Pipkorn, Sidharth V. Puram, Ryan S. Jackson & Cameron C. Wick

  2. Division of Adult Audiology, Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Emma Y. Travis, Susan K. Wong, Cathryn Collopy Rowling & Kate McClannahan

  3. Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA

    Sidharth V. Puram

  4. Department of Medical Oncology, Washington University School of Medicine, St. Louis, MO, USA

    Douglas R. Adkins & Peter Oppelt

  5. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA

    Wade L. Thorstad

  6. Department of Otolaryngology – Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Jose P. Zevallos & Angela L. Mazul

Authors
  1. David S. Lee
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  2. Emma Y. Travis
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  3. Susan K. Wong
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  4. Marie-Ange Munyemana
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  5. Lauren Mueller
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  16. Kate McClannahan
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  17. Angela L. Mazul
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by David S. Lee, Emma Y. Travis BS, Susan K. Wong BA, Marie-Ange Munyemana BA, Lauren Mueller BA, and Cathryn Collopy Rowling AuD. The first draft of the manuscript was written by David S. Lee, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to David S. Lee.

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Competing interests

David S. Lee, none. Emma Y. Travis, none. Susan K. Wong, none. Marie-Ange Munyemana, none. Lauren Mueller, none. Cathryn Collopy Rowling, none. Amanda J. Ortman, none. Jason T. Rich, none. Patrik Pipkorn, none. Sidharth V. Puram, none. Ryan S. Jackson, none. Douglas R. Adkins: research grant, Merck, Cue Biopharma, Hookipa Pharma, Blueprint Medicine, Exelixis, Kura, Vaccinex, Pfizer, Eli Lilly, Celgene/BMS, Novartis, AstraZeneca, Atara Bio, Aduro, Sensei, Matrix Biomed, ISA, Debiopharm, Epizyme, Shanghai De Novo, Roche, Gilead, Rubius; advisory board: Merck, Cue Biopharma, Blueprint Medicine, Exelixis, Kura, TwoX. Peter Oppelt, none. Wade L. Thorstad, employee: Elekta, Inc. Cameron C. Wick, consultant: Stryker and Cochlear Ltd. Jose Zevallos; advisory board: Summit Biolabs; Scientific Founder and Chair of the Board: Summit Biolabs; Droplet Biosciences. Kate McClannahan, none. Angela L. Mazul, none.

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Lee, D.S., Travis, E.Y., Wong, S.K. et al. Trends in ototoxicity monitoring among cisplatin-treated patients with cancer. J Cancer Surviv (2024). https://doi.org/10.1007/s11764-024-01586-3

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