ABR evaluation of ototoxicity in cancer patients receiving cisplatin or carboplatin

Abstract

The development of ototoxicity was evaluated using auditory brainstem response (ABR) in cancer patients randomized to receive a cisplatin-based chemotherapy (cisplatin dose: 70 mg/m2) or a carboplatin-based chemotherapy (carboplatin dose: 250 mg/m2). The ABR measurements were performed in a sound-treated room using 2000 clicks of alternating polarity at an intensity of 100 dB PESPL presented to the patients at a rate of 21 clicks per second. Of 59 patients, 21 (9 in the cisplatin group and 12 in the carboplatin group) met our pre-established criteria and were included in the ototoxicity study. Two patients of the cisplatin group developed evidence of clinically occult ototoxicity after two cycles of chemotherapy; the latency of wave V of the ABR increased significantly from 5.874 to 6.336 msec and from 5.826 to 6.458 msec in both patients; these patients had a hearing loss detected by conventional audiometry (125 to 8,000 Hz) after five and six cycles of chemotherapy, respectively. None of the 12 examined carboplatin patients developed ABR-measured ototoxicity or abnormal audiograms during treatment. Our results suggest that ABR might prove to be useful in detecting early hearing deterioration from cisplatin.

Monitoramento auditivo na ototoxidade

“…Some studies show that the BERA is efficacious in the early detection of cisplatin-induced hearing loss, by following Wave V as a minimum hearing level [26][27][28] . High frequency audiometry is being mentioned in the international literature as a sensitive procedure in the early detection of hearing alterations caused by ototoxic medication, and many investigators have stated that hearing monitoring is fundamental in order to avoid degenerative processes occurring to the cochlea spiral process 7,11,13,16,17,20,25,[28][29][30][31][32][33] , although there is still no consensus as to the criteria used for results interpretation.…”

Possible Ototoxic Effects of Topical Rifamycin Application: An Electrophysiological and Ultrastructural Study

“…De Lauretis et al (16) showed with clinical audiological evidence that the value of ABR was significantly successful in early detection of ototoxicity of cisplatin. Campbell and Durrant (17) argued in their first study on ototoxicity that threshold differences of >15 dB in ≥1 frequencies or >20 dB in a single frequency were considered as a significant indication of change; however, in later studies, these criteria were found to exceed even in those who did not use ototoxic drug.…”

Ototoxic Hearing Loss and Retinoblastoma Patients

“…function due to administration of ototoxic medications in adults (DeLauretis et al,1999). However, some studies have questioned the sensitivity of ABR test results in monitoring platinum-compound ototoxicity in children (Weatherly et al, 1991).…”