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.
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.
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).
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.
Survivors should be aware of risk factors associated with ototoxicity. Referrals to audiologists before, during, and after cisplatin treatment is recommended.
Journal of cancer survivorship : research and practice. 2023 Jan 13 [Epub ahead of print]
Victoria A Sanchez, Paul C Dinh, Jennessa Rooker, Patrick O Monahan, Sandra K Althouse, Chunkit Fung, Howard D Sesso, Lawrence H Einhorn, M Eileen Dolan, Robert D Frisina, Lois B Travis
Department of Otolaryngology-Head & Neck Surgery, University of South Florida, 12901 Bruce B. Downs Blvd., MDC 73, Tampa, FL, 33612, USA. ., Department of Medical Oncology, Indiana University, Indianapolis, IN, USA., College of Nursing, University of South Florida, Tampa, FL, USA., Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA., J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA., Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA., Department of Medicine, University of Chicago, Chicago, IL, USA., Department of Medical Engineering, University of South Florida, Tampa, FL, USA.