Analysis of Cisplatin-Induced Ototoxicity Risk Factors in Iranian Patients with Solid Tumors: a Cohort, Prospective and Single Institute Study
Asian Pacific journal of cancer prevention : APJCP(2017)
摘要
Background: Cisplatin has been associated with irreversible hearing damage. Up to now, there is no therapeutic
intervention showing benefit in preventing Cisplatin-induced ototoxicity. The aim of this study was to determine
risk factors contributing to hearing impairment after cisplatin administration in Iranian patients. Methods: Hearing
thresholds of 124 patients before and after cisplatin administration were assessed with reference to pure-tone audiometry
averages at several frequencies from 2006 to 2010. Mean values were calculated at each tested frequency in each ear at
baseline and subsequent follow-up audiometry. Hearing impairment was assessed with the Münster score. Results: The
mean age at diagnosis and the median cumulative Cisplatin dose were 47.3 years and 453.8 milligrams, respectively.
Bilateral hearing loss, mostly of grade 1, and tinnitus were detected in 26% and 3.2% of patients. Logistic regression
analysis showed that a high cumulative dose of cisplatin was the most important risk factor for developing hearing
damage (P=0.034). The most significant changes in the status of the auditory system and the most severe threshold
shift from base line (35 dB) were observed at a frequency of 8 kHz. Also, patients who received higher individual
doses of Cisplatin showed significantly more tinnitus (P=0.002). Conclusions: The results are testament to benefits of
routine audiometric monitoring program during cisplatin-based chemotherapy. Further research should be performed
to understand other risk factors, such as genetic predictors of Cisplatin-induced ototoxicity.
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