High prevalence of cisplatin-induced ototoxicity in Cape Town, South Africa

S Afr Med J. 2014 Apr;104(4):288-91. doi: 10.7196/samj.7389.

Abstract

Background: Cisplatin is administered as the first-line treatment of soft-tissue cancers. It has a reported cure rate of up to 85%, but is associated with a high incidence of ototoxicity, characterised by irreversible bilateral hearing loss and affecting 23 - 50% of adults who receive the drug.

Objectives: To determine the incidence of cisplatin-induced ototoxicity at Groote Schuur Hospital (GSH), Cape Town, South Africa.

Methods: retrospective cross-sectional study of cisplatin-receiving cancer patients attending GSH between January 2006 and August 2011.

Results: A total of 377 patients were recorded as receiving cisplatin therapy during the study period. A 300% increase in new cisplatin-receiving patients receiving audiological monitoring was observed between 2006 and 2010. However, only patients with all clinical data as well as baseline and follow-up audiometric analyses were investigated. One hundred and seven such patients were identified, 55.1% of whom developed cisplatin-induced ototoxicity while receiving high-dose (> or = 60 mg/m2) cisplatin treatment. Higher cumulative cisplatin dosages were associated with development of significant hearing loss (p = 0.027). The odds of developing cisplatin-induced hearing loss were elevated for patients with head and neck tumours and lymphoma (p = 0.0465 and p = 0.0563, respectively) and were significantly lower for those with reproductive cancers (p = 0.0371).

Conclusion: Comprehensive audiological monitoring should be available for every patient during cisplatin treatment to minimise the development of disabling hearing loss.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects*
  • Audiometry, Pure-Tone
  • Cisplatin / adverse effects*
  • Cohort Studies
  • Cross-Sectional Studies
  • Dose-Response Relationship, Drug
  • Female
  • Genital Neoplasms, Female / drug therapy
  • Head and Neck Neoplasms / drug therapy
  • Hearing Loss, Bilateral / chemically induced*
  • Hearing Loss, Bilateral / epidemiology
  • Humans
  • Incidence
  • Lymphoma / drug therapy
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Retrospective Studies
  • Risk Factors
  • South Africa / epidemiology
  • Young Adult

Substances

  • Antineoplastic Agents
  • Cisplatin