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

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

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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 (6 mg/m(2), daily infusions, 20-25 days) with concomitant accelerated radiotherapy (70 Gy). Results: Audiometry up to 16 kHz was performed before therapy and 31 days (median) post-treatment. The total incidence of ototoxicity in CTCAEv3.0 was 31% in audiograms up to 8 kHz, and 5% of ears tested qualified for HAs due to treatment. The mean hearing loss at speech frequencies was 2.6 dB (SD 5.7) and 2.3 dB (SD 9.2) at PTA 1-2-4 kHz air-conduction and bone-conduction, respectively. The mean hearing loss at ultra-high frequencies (PTA AC 8-10-12.5 kHz) was 9.0 dB (SD 8.1). Low-dose cisplatin CRT caused less acute hearing loss (CTCAE 31%), compared to high-dose cisplatin CRT (CTCAE 78%). Conclusions: Low-dose cisplatin chemo-irradiation for HNSCC is a relatively safe treatment protocol with respect to ototoxicity. Crown copyright (C) 2008 Published by Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 89 (2008) 38-43
Original languageEnglish
Pages (from-to)38-43
JournalRadiotherapy and oncology
Issue number1
Publication statusPublished - 2008

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