Comprehensive audiometric analysis of hearing impairment and tinnitus after cisplatin-based chemotherapy in survivors of adult-onset cancer

Robert D. Frisina, Heather E. Wheeler, Sophie D. Fossa, Sarah L. Kerns, Chunkit Fung, Howard D. Sesso, Patrick O. Monahan, Darren R. Feldman, Robert Hamilton, David J. Vaughn, Clair J. Beard, Amy Budnick, Eileen M. Johnson, Shirin Ardeshir-Rouhani-fard, Lawrence H. Einhorn, Steven E Lipshultz, M. Eileen Dolan, Lois B. Travis

Research output: Contribution to journalArticle

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Abstract

Purpose: Cisplatin is widely used but highly ototoxic. Effects of cumulative cisplatin dose on hearing loss have not been comprehensively evaluated in survivors of adult-onset cancer. Patients and Methods: Comprehensive audiological measures were conducted on 488 North American male germ cell tumor (GCT) survivors in relation to cumulative cisplatin dose, including audiograms (0.25 to 12 kHz), tests of middle ear function, and tinnitus. American Speech-Language-Hearing Association criteria defined hearing loss severity. The geometric mean of hearing thresholds (0.25 to 12 kHz) summarized overall hearing status consistent with audiometric guidelines. Patients were sorted into quartiles of hearing thresholds of age- and sex-matched controls. Results: Increasing cumulative cisplatin dose (median, 400 mg/m2; range, 200 to 800 mg/m2) was significantly related to hearing loss at 4, 6, 8, 10, and 12 kHz (P trends,.021 to <.001): every 100 mg/m2 increase resulted in a 3.2-dB impairment in age-adjusted overall hearing threshold (4 to 12 kHz; P<.001). Cumulative cisplatin doses. 300 mg/m2 were associated with greater American Speech-Language-Hearing Association-defined hearing loss severity (odds ratio, 1.59; P =.0066) and worse normative-matched quartiles (odds ratio, 1.33; P =.093) compared with smaller doses. Almost one in five (18%) patients had severe to profound hearing loss. Tinnitus (40% patients) was significantly correlated with reduced hearing at each frequency (P<.001). Noise-induced damage (10% patients) was unaffected by cisplatin dose (P =.59). Hypertension was significantly related (P =.0066) to overall hearing threshold (4 to 12 kHz) in age- and cisplatin dose-adjusted analyses. Middle ear deficits occurred in 22.3% of patients but, as expected, were not related to cytotoxic drug dosage. Conclusion: Follow-up of adult-onset cancer survivors given cisplatin should include routine inquiry for hearing status and tinnitus, referral to audiologists as clinically indicated, and hypertension control. Patients should be urged to avoid noise exposure, ototoxic drugs, and other factors that further damage hearing.

Original languageEnglish (US)
Pages (from-to)2712-2720
Number of pages9
JournalJournal of Clinical Oncology
Volume34
Issue number23
DOIs
StatePublished - Aug 10 2016
Externally publishedYes

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Tinnitus
Hearing Loss
Cisplatin
Hearing
Survivors
Drug Therapy
Neoplasms
American Speech-Language-Hearing Association
Middle Ear
Noise
Odds Ratio
Hypertension
Pharmaceutical Preparations
Referral and Consultation
Guidelines

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

Cite this

Comprehensive audiometric analysis of hearing impairment and tinnitus after cisplatin-based chemotherapy in survivors of adult-onset cancer. / Frisina, Robert D.; Wheeler, Heather E.; Fossa, Sophie D.; Kerns, Sarah L.; Fung, Chunkit; Sesso, Howard D.; Monahan, Patrick O.; Feldman, Darren R.; Hamilton, Robert; Vaughn, David J.; Beard, Clair J.; Budnick, Amy; Johnson, Eileen M.; Ardeshir-Rouhani-fard, Shirin; Einhorn, Lawrence H.; Lipshultz, Steven E; Dolan, M. Eileen; Travis, Lois B.

In: Journal of Clinical Oncology, Vol. 34, No. 23, 10.08.2016, p. 2712-2720.

Research output: Contribution to journalArticle

Frisina, RD, Wheeler, HE, Fossa, SD, Kerns, SL, Fung, C, Sesso, HD, Monahan, PO, Feldman, DR, Hamilton, R, Vaughn, DJ, Beard, CJ, Budnick, A, Johnson, EM, Ardeshir-Rouhani-fard, S, Einhorn, LH, Lipshultz, SE, Dolan, ME & Travis, LB 2016, 'Comprehensive audiometric analysis of hearing impairment and tinnitus after cisplatin-based chemotherapy in survivors of adult-onset cancer', Journal of Clinical Oncology, vol. 34, no. 23, pp. 2712-2720. https://doi.org/10.1200/JCO.2016.66.8822
Frisina, Robert D. ; Wheeler, Heather E. ; Fossa, Sophie D. ; Kerns, Sarah L. ; Fung, Chunkit ; Sesso, Howard D. ; Monahan, Patrick O. ; Feldman, Darren R. ; Hamilton, Robert ; Vaughn, David J. ; Beard, Clair J. ; Budnick, Amy ; Johnson, Eileen M. ; Ardeshir-Rouhani-fard, Shirin ; Einhorn, Lawrence H. ; Lipshultz, Steven E ; Dolan, M. Eileen ; Travis, Lois B. / Comprehensive audiometric analysis of hearing impairment and tinnitus after cisplatin-based chemotherapy in survivors of adult-onset cancer. In: Journal of Clinical Oncology. 2016 ; Vol. 34, No. 23. pp. 2712-2720.
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abstract = "Purpose: Cisplatin is widely used but highly ototoxic. Effects of cumulative cisplatin dose on hearing loss have not been comprehensively evaluated in survivors of adult-onset cancer. Patients and Methods: Comprehensive audiological measures were conducted on 488 North American male germ cell tumor (GCT) survivors in relation to cumulative cisplatin dose, including audiograms (0.25 to 12 kHz), tests of middle ear function, and tinnitus. American Speech-Language-Hearing Association criteria defined hearing loss severity. The geometric mean of hearing thresholds (0.25 to 12 kHz) summarized overall hearing status consistent with audiometric guidelines. Patients were sorted into quartiles of hearing thresholds of age- and sex-matched controls. Results: Increasing cumulative cisplatin dose (median, 400 mg/m2; range, 200 to 800 mg/m2) was significantly related to hearing loss at 4, 6, 8, 10, and 12 kHz (P trends,.021 to <.001): every 100 mg/m2 increase resulted in a 3.2-dB impairment in age-adjusted overall hearing threshold (4 to 12 kHz; P<.001). Cumulative cisplatin doses. 300 mg/m2 were associated with greater American Speech-Language-Hearing Association-defined hearing loss severity (odds ratio, 1.59; P =.0066) and worse normative-matched quartiles (odds ratio, 1.33; P =.093) compared with smaller doses. Almost one in five (18{\%}) patients had severe to profound hearing loss. Tinnitus (40{\%} patients) was significantly correlated with reduced hearing at each frequency (P<.001). Noise-induced damage (10{\%} patients) was unaffected by cisplatin dose (P =.59). Hypertension was significantly related (P =.0066) to overall hearing threshold (4 to 12 kHz) in age- and cisplatin dose-adjusted analyses. Middle ear deficits occurred in 22.3{\%} of patients but, as expected, were not related to cytotoxic drug dosage. Conclusion: Follow-up of adult-onset cancer survivors given cisplatin should include routine inquiry for hearing status and tinnitus, referral to audiologists as clinically indicated, and hypertension control. Patients should be urged to avoid noise exposure, ototoxic drugs, and other factors that further damage hearing.",
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T1 - Comprehensive audiometric analysis of hearing impairment and tinnitus after cisplatin-based chemotherapy in survivors of adult-onset cancer

AU - Frisina, Robert D.

AU - Wheeler, Heather E.

AU - Fossa, Sophie D.

AU - Kerns, Sarah L.

AU - Fung, Chunkit

AU - Sesso, Howard D.

AU - Monahan, Patrick O.

AU - Feldman, Darren R.

AU - Hamilton, Robert

AU - Vaughn, David J.

AU - Beard, Clair J.

AU - Budnick, Amy

AU - Johnson, Eileen M.

AU - Ardeshir-Rouhani-fard, Shirin

AU - Einhorn, Lawrence H.

AU - Lipshultz, Steven E

AU - Dolan, M. Eileen

AU - Travis, Lois B.

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N2 - Purpose: Cisplatin is widely used but highly ototoxic. Effects of cumulative cisplatin dose on hearing loss have not been comprehensively evaluated in survivors of adult-onset cancer. Patients and Methods: Comprehensive audiological measures were conducted on 488 North American male germ cell tumor (GCT) survivors in relation to cumulative cisplatin dose, including audiograms (0.25 to 12 kHz), tests of middle ear function, and tinnitus. American Speech-Language-Hearing Association criteria defined hearing loss severity. The geometric mean of hearing thresholds (0.25 to 12 kHz) summarized overall hearing status consistent with audiometric guidelines. Patients were sorted into quartiles of hearing thresholds of age- and sex-matched controls. Results: Increasing cumulative cisplatin dose (median, 400 mg/m2; range, 200 to 800 mg/m2) was significantly related to hearing loss at 4, 6, 8, 10, and 12 kHz (P trends,.021 to <.001): every 100 mg/m2 increase resulted in a 3.2-dB impairment in age-adjusted overall hearing threshold (4 to 12 kHz; P<.001). Cumulative cisplatin doses. 300 mg/m2 were associated with greater American Speech-Language-Hearing Association-defined hearing loss severity (odds ratio, 1.59; P =.0066) and worse normative-matched quartiles (odds ratio, 1.33; P =.093) compared with smaller doses. Almost one in five (18%) patients had severe to profound hearing loss. Tinnitus (40% patients) was significantly correlated with reduced hearing at each frequency (P<.001). Noise-induced damage (10% patients) was unaffected by cisplatin dose (P =.59). Hypertension was significantly related (P =.0066) to overall hearing threshold (4 to 12 kHz) in age- and cisplatin dose-adjusted analyses. Middle ear deficits occurred in 22.3% of patients but, as expected, were not related to cytotoxic drug dosage. Conclusion: Follow-up of adult-onset cancer survivors given cisplatin should include routine inquiry for hearing status and tinnitus, referral to audiologists as clinically indicated, and hypertension control. Patients should be urged to avoid noise exposure, ototoxic drugs, and other factors that further damage hearing.

AB - Purpose: Cisplatin is widely used but highly ototoxic. Effects of cumulative cisplatin dose on hearing loss have not been comprehensively evaluated in survivors of adult-onset cancer. Patients and Methods: Comprehensive audiological measures were conducted on 488 North American male germ cell tumor (GCT) survivors in relation to cumulative cisplatin dose, including audiograms (0.25 to 12 kHz), tests of middle ear function, and tinnitus. American Speech-Language-Hearing Association criteria defined hearing loss severity. The geometric mean of hearing thresholds (0.25 to 12 kHz) summarized overall hearing status consistent with audiometric guidelines. Patients were sorted into quartiles of hearing thresholds of age- and sex-matched controls. Results: Increasing cumulative cisplatin dose (median, 400 mg/m2; range, 200 to 800 mg/m2) was significantly related to hearing loss at 4, 6, 8, 10, and 12 kHz (P trends,.021 to <.001): every 100 mg/m2 increase resulted in a 3.2-dB impairment in age-adjusted overall hearing threshold (4 to 12 kHz; P<.001). Cumulative cisplatin doses. 300 mg/m2 were associated with greater American Speech-Language-Hearing Association-defined hearing loss severity (odds ratio, 1.59; P =.0066) and worse normative-matched quartiles (odds ratio, 1.33; P =.093) compared with smaller doses. Almost one in five (18%) patients had severe to profound hearing loss. Tinnitus (40% patients) was significantly correlated with reduced hearing at each frequency (P<.001). Noise-induced damage (10% patients) was unaffected by cisplatin dose (P =.59). Hypertension was significantly related (P =.0066) to overall hearing threshold (4 to 12 kHz) in age- and cisplatin dose-adjusted analyses. Middle ear deficits occurred in 22.3% of patients but, as expected, were not related to cytotoxic drug dosage. Conclusion: Follow-up of adult-onset cancer survivors given cisplatin should include routine inquiry for hearing status and tinnitus, referral to audiologists as clinically indicated, and hypertension control. Patients should be urged to avoid noise exposure, ototoxic drugs, and other factors that further damage hearing.

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