{"title":"Comparative Analysis of Hearing Loss Induced by Cisplatin Versus Carboplatin in Locally Advanced Nasopharyngeal Carcinoma: Early to Mid-Term Findings.","authors":"Danfan Lin, Yanfei Li, Xiaoyan Han, Xiaofei Yuan, Shuting Wu, Wenxuan Lu, Zilu Chen, Xiaolan Jiang, Xiong Liu, Haoran Huang","doi":"10.1111/coa.14299","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>To investigate the clinical course of ototoxicity induced by induction chemotherapy followed by concurrent chemoradiotherapy (iCRT), and to determine whether replacing cisplatin with carboplatin in iCRT can reduce hearing damage in patients with nasopharyngeal carcinoma (NPC).</p><p><strong>Methods: </strong>This retrospective study aimed to evaluate hearing loss in patients with locally advanced NPC treated with carboplatin or cisplatin-based iCRT. Bone conduction hearing thresholds were measured before treatment and at 1 week, 3-6 months and 12-18 months following treatment. Changes in hearing loss were assessed using bone conduction threshold values, threshold shifts from baseline, as well as the Common Terminology Criteria for Adverse Events (CTCAE) grading system.</p><p><strong>Result: </strong>A total of 156 ears were examined. After iCRT, hearing loss was observed immediately after the conclusion of treatment, peaking at 3-6 months and partially recovering at 12-18 months. At high frequencies, the shifts in hearing thresholds were more pronounced in the cisplatin group compared to the carboplatin group 3-6 months after treatment (p = 0.005), with median hearing threshold shifts of 15 (5.30) dB and 10 (0.15) dB respectively. However, no significant difference was observed at the end of the follow-up period. Similarly, a statistically significant difference in CTCAE scores was observed between the two groups only at 3-6 months following treatment (p = 0.047); patients in the cisplatin group experienced poorer hearing outcomes.</p><p><strong>Conclusion: </strong>In patients with NPC treated with iCRT, cisplatin is associated with a slightly higher incidence of early high-frequency hearing loss compared to carboplatin. However, this difference diminishes during the mid-term follow-up period, making the substitution of carboplatin unnecessary.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Otolaryngology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/coa.14299","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: To investigate the clinical course of ototoxicity induced by induction chemotherapy followed by concurrent chemoradiotherapy (iCRT), and to determine whether replacing cisplatin with carboplatin in iCRT can reduce hearing damage in patients with nasopharyngeal carcinoma (NPC).
Methods: This retrospective study aimed to evaluate hearing loss in patients with locally advanced NPC treated with carboplatin or cisplatin-based iCRT. Bone conduction hearing thresholds were measured before treatment and at 1 week, 3-6 months and 12-18 months following treatment. Changes in hearing loss were assessed using bone conduction threshold values, threshold shifts from baseline, as well as the Common Terminology Criteria for Adverse Events (CTCAE) grading system.
Result: A total of 156 ears were examined. After iCRT, hearing loss was observed immediately after the conclusion of treatment, peaking at 3-6 months and partially recovering at 12-18 months. At high frequencies, the shifts in hearing thresholds were more pronounced in the cisplatin group compared to the carboplatin group 3-6 months after treatment (p = 0.005), with median hearing threshold shifts of 15 (5.30) dB and 10 (0.15) dB respectively. However, no significant difference was observed at the end of the follow-up period. Similarly, a statistically significant difference in CTCAE scores was observed between the two groups only at 3-6 months following treatment (p = 0.047); patients in the cisplatin group experienced poorer hearing outcomes.
Conclusion: In patients with NPC treated with iCRT, cisplatin is associated with a slightly higher incidence of early high-frequency hearing loss compared to carboplatin. However, this difference diminishes during the mid-term follow-up period, making the substitution of carboplatin unnecessary.
期刊介绍:
Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with:
current otorhinolaryngological practice
audiology, otology, balance, rhinology, larynx, voice and paediatric ORL
head and neck oncology
head and neck plastic and reconstructive surgery
continuing medical education and ORL training
The emphasis is on high quality new work in the clinical field and on fresh, original research.
Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject.
• Negative/null results
In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.