Hearing loss due to concurrent daily low-dose cisplatin chemoradiation for locally advanced head and neck cancer

Zuur, Charlotte L.; Simis, Yvonne J.W.; Verkaik, Roxanna S.; Schornagel, Jan H.; Balm, Alfons J.M.; Dreschler, Wouter A.; Rasch, Coen R.N.

doi:10.1016/j.radonc.2008.06.003

« Previous Next »Radiotherapy & Oncology
Volume 89, Issue 1 , Pages 38-43, October 2008

Hearing loss due to concurrent daily low-dose cisplatin chemoradiation for locally advanced head and neck cancer

Charlotte L. Zuur
- Department of Head and Neck Surgery, VU University Medical Center Amsterdam, The Netherlands
- Corresponding author. Charlotte L. Zuur, Department of Head and Neck Surgery, VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, PO BOX 7057 1007 MB Amsterdam, The Netherlands.
Yvonne J.W. Simis
- Department of Audiology, Academical Medical Centre Amsterdam, The Netherlands
Roxanna S. Verkaik
- Department of Radiation Oncology The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
Jan H. Schornagel
- Department of Medical Oncology The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
Alfons J.M. Balm
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Otorhinolaryngology, Academical Medical Centre Amsterdam, The Netherlands
Wouter A. Dreschler
- Department of Audiology, Academical Medical Centre Amsterdam, The Netherlands
Coen R.N. Rasch
- Department of Medical Oncology The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

Received 29 May 2007; received in revised form 4 June 2008; accepted 18 June 2008. published online 15 August 2008.

Abstract

Background and purpose

Cisplatin-based chemo-irradiation (CRT) is increasingly used for head and neck squamous cell carcinoma (HNSCC). We aimed to assess hearing deterioration due to low-dose cisplatin chemoradiation and to compare the observed hearing loss with hearing loss in our previously described high-dose cisplatin CRT cohort.

Materials and methods

A prospective analysis of hearing thresholds at low and (ultra)-high frequencies obtained before and after treatment in 60 patients. Patients received low-dose cisplatin (6mg/m², daily infusions, 20–25 days) with concomitant accelerated radiotherapy (70Gy).

Results

Audiometry up to 16kHz was performed before therapy and 31 days (median) post-treatment. The total incidence of ototoxicity in CTCAEv3.0 was 31% in audiograms up to 8kHz, and 5% of ears tested qualified for HAs due to treatment. The mean hearing loss at speech frequencies was 2.6dB (SD 5.7) and 2.3dB (SD 9.2) at PTA 1–2–4kHz air-conduction and bone-conduction, respectively. The mean hearing loss at ultra-high frequencies (PTA AC 8–10–12.5kHz) was 9.0dB (SD 8.1). Low-dose cisplatin CRT caused less acute hearing loss (CTCAE 31%), compared to high-dose cisplatin CRT (CTCAE 78%).