Cisplatin-based chemotherapy: Add high-frequency audiometry in the regimen

Arora, Rajender Singh; Thakur, Jagdeep S; Azad, Ramesh K.; Mohindroo, NK; Sharma, Dev; Seam, RK

doi:10.4103/0019-509x.55551

Cited by 49 publications

(24 citation statements)

References 21 publications

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“…Similarly, Kopelman et al (1988) [13] reported that 100% of their patients with advanced cancers showed some degree of hearing loss, while Nagy et al (1999) [14] revealed that 36% of the 53 patients with oesophageal, lung or head and neck cancer presented with cisplatin-associated ototoxicity. Data from India also revealed similar findings [4, 10]. Whitehorn et al (2014) [11] reported that 55.1% of the patients in their retrospective study developed ototoxicity while receiving high-dose (≥60 mg/m2) cisplatin treatment.…”

Section: Introductionmentioning

confidence: 57%

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Research protocol: Cisplatin-associated ototoxicity amongst patients receiving cancer chemotherapy and the feasibility of an audiological monitoring program

2017

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BackgroundCisplatin is an anti-cancer chemotherapy drug classified as an alkylating agent. It is used for the treatment of a variety of cancers such as cervical, breast, stomach, prostate, bladder and oesophageal, to name a few. However due to its expansive toxicity profile, patients receiving cisplatin can experience high frequency hearing loss, a side effect known as ototoxicity. The dearth of information on the extent and severity of cisplatin-associated ototoxicity in South Africa prevents the implementation of a context-specific audiological monitoring programme.MethodsThis study aims to determine the extent and severity of ototoxicity amongst patients with cervical cancer, receiving cisplatin-based chemotherapy and hence the feasibility of an ototoxicity monitoring program in the province of KwaZulu-Natal, South Africa. A concurrent mixed methods design will be employed in the study. This longitudinal study will involve interviewing oncology nurses, oncologists, pharmacists and audiologists to assess the level of awareness to ototoxicity, as well as conducting diagnostic audiological evaluations at regular intervals on 78 patients with cervical cancer to ascertain the progression of hearing loss during and after chemotherapy. The feasibility of the monitoring program will be assessed as a parallel process to the audiological evaluations, where patient outcomes and cost implications to the patient and the health sector will be considered. Data will be subjected to statistical analyses so as to strengthen knowledge in the field and inform appropriate policies, and healthcare providers.DiscussionThis study is the first longitudinal study in South Africa to determine the ototoxic effects of cisplatin therapy on patients diagnosed with cervical cancer. Thus, the results generated from this study is likely to bring novel information to the fore using an evidence-based approach that will influence policy and clinical practice which can vastly improve the quality of life of patients undergoing chemotherapy. Mitigation of any further loss in the quality of life of affected patients is of paramount importance and the data generated from this project can lay the basis for further effective dialogue towards policy formulation on an ototoxic monitoring programme and the resultant strengthening of health systems in limited resource settings.Electronic supplementary materialThe online version of this article (10.1186/s12905-017-0486-8) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 57%

“…However, while cisplatin chemotherapy is the treatment modality in advanced carcinogenesis, the resulting toxicity profile from the use of such regimens is expansive and affects the gastrointestinal, haematologic, renal and auditory systems [4]. …”

Section: Introductionmentioning

confidence: 99%

Research protocol: Cisplatin-associated ototoxicity amongst patients receiving cancer chemotherapy and the feasibility of an audiological monitoring program

2017

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“…Since its discovery in the 1970s [7], cisplatin continues to be hailed as one of the most potent cancer chemotherapeutics in children and adults, as it is unique and unmatched in its effectiveness against many cancers [4], namely, osteogenic sarcoma, medulloblastoma, testicular, cervical, and ovarian cancers [8]. Similarly, its toxicity profile is expansive, involving the gastrointestinal, hematologic, renal, and auditory systems [8].…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, its toxicity profile is expansive, involving the gastrointestinal, hematologic, renal, and auditory systems [8]. While the use of saline hydration and mannitol diuresis may prevent nephrotoxicity, neurotoxicity is still not curable or preventable [9].…”

Section: Introductionmentioning

confidence: 99%

Cisplatin-Associated Ototoxicity: A Review for the Health Professional

Paken

Govender

Pillay

et al. 2016

Journal of Toxicology

109

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Cisplatin is an effective drug used in the treatment of many cancers, yet its ototoxic potential places cancer patients, exposed to this drug, at risk of hearing loss, thus negatively impacting further on a patient's quality of life. It is paramount for health care practitioners managing such patients to be aware of cisplatin's ototoxic properties and the clinical signs to identify patients at risk of developing hearing loss. English peer-reviewed articles from January 1975 to July 2015 were assessed from PubMed, Science Direct, and Ebscohost. Seventy-nine articles and two books were identified for this review, using MeSH terms and keywords such as “ototoxicity”, “cisplatin”, “hearing loss”, and “ototoxicity monitoring”. This review provides an up-to-date overview of cisplatin-associated ototoxicity, namely, its clinical features, incidence rates, and molecular and cellular mechanisms and risk factors, to health care practitioners managing the patient with cancer, and highlights the need for a team-based approach to complement an audiological monitoring programme to mitigate any further loss in the quality of life of affected patients, as there is currently no otoprotective agent recommended routinely for the prevention of cisplatin-associated ototoxicity. It also sets the platform for effective dialogue towards policy formulation and strengthening of health systems in developing countries.

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“…This damage occurs in a relatively orderly manner of base (high frequency) to apex (low frequency) destruction [10] primarily of the outer hair cells, which are sensory receptor cells that provide for the large dynamic range and exacting frequency selectivity that characterizes human hearing. Damage also occurs to the marginal cells of the stria vascularis [11][12][13][14], which provides the electrochemical drive for the outer hair cells and spiral ganglion cells of the auditory nerve.…”

Section: Introductionmentioning

confidence: 99%

Proposed comprehensive ototoxicity monitoring program for VA healthcare (COMP-VA)

Konrad-Martin¹,

Reavis²,

McMillan³

et al. 2014

J Rehabil Res Dev

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Abstract-Prevention and rehabilitation of hearing loss and tinnitus, the two most commonly awarded service-connected disabilities, are high priority initiatives in the Department of Veterans Affairs (VA). At least 4,000 Veterans, most with significant hearing loss, will receive cisplatin this year, with more than half sustaining permanent hearing shift and nearly 40% developing new tinnitus. With improved survivability following cancer treatment, Veterans treated with cisplatin are approached with the dual goals of effective treatment and preserved quality of life. This article describes COMP-VA, a comprehensive ototoxicity monitoring program developed for VA patients receiving cisplatin. The program includes an individualized pretreatment prediction model that identifies the likelihood of hearing shift given cisplatin dose and patient factors. It supports both manual and automated hearing testing with a newly developed portable audiometer capable of performing the recommended procedures on the chemotherapy unit during treatment. It also includes objective methods for identifying outer hair cell changes and predicting audiogram changes using distortion-product otoacoustic emissions. We describe this program of evidence-based ototoxicity monitoring protocols using a case example to give the reader an understanding of how this program would be applied, along with a plan for future work to accomplish the final stages of program development.

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Cisplatin-based chemotherapy: Add high-frequency audiometry in the regimen

Abstract: As use of high-frequency audiometry is still limited in research work only, we need a strict protocol of adding high-frequency audiometry in the cisplatin-based chemotherapy regimen.

Cited by 49 publications

References 21 publications

Research protocol: Cisplatin-associated ototoxicity amongst patients receiving cancer chemotherapy and the feasibility of an audiological monitoring program

Research protocol: Cisplatin-associated ototoxicity amongst patients receiving cancer chemotherapy and the feasibility of an audiological monitoring program

Cisplatin-Associated Ototoxicity: A Review for the Health Professional

Proposed comprehensive ototoxicity monitoring program for VA healthcare (COMP-VA)

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