Risk Profiles for Sensorineural Hearing Loss in Patients with Head and Neck Cancer Receiving Cisplatin-based Chemoradiation

Phoebe Shorter; Fiona Harden; Rebecca Owen; Benedict Panizza; Bryan Burmeister; Jennifer Sommerville; Kerrie Mengersen; Matthew Foote

doi:10.1016/j.jmir.2016.11.005

Risk Profiles for Sensorineural Hearing Loss in Patients with Head and Neck Cancer Receiving Cisplatin-based Chemoradiation

J Med Imaging Radiat Sci. 2017 Mar;48(1):61-67. doi: 10.1016/j.jmir.2016.11.005. Epub 2016 Dec 26.

Authors

Phoebe Shorter¹, Fiona Harden², Rebecca Owen³, Benedict Panizza⁴, Bryan Burmeister⁵, Jennifer Sommerville⁶, Kerrie Mengersen², Matthew Foote⁵

Affiliations

¹ Division of Cancer Services, Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; School of Science and Engineering, Queensland University of Technology, Brisbane, Queensland, Australia. Electronic address: p.truswell@student.qut.edu.au.
² School of Science and Engineering, Queensland University of Technology, Brisbane, Queensland, Australia.
³ Department of Radiation Oncology, Radiation Oncology Mater Centre, Brisbane, Queensland, Australia.
⁴ Division of Surgery, Department of Otolaryngology - Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
⁵ Division of Cancer Services, Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
⁶ Department of Diagnostic Radiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

PMID: 31047212
DOI: 10.1016/j.jmir.2016.11.005

Abstract

Objective: Sensorineural hearing loss (SNHL) is a significant toxicity experienced by some patients undergoing cisplatin-based chemoradiation therapy for head and neck cancer. Therefore, SNHL risk profiles were created based on demographics, hearing thresholds, and treatment parameters.

Methods: Thirty-eight patients with squamous cell carcinoma of the head and neck, treated with postoperative or definitive cisplatin-based chemoradiation at the Princess Alexandra Hospital between 2010 and 2013, were retrospectively reviewed. Patients with pretreatment otologic problems were excluded. Regression models analysed the contributions of collected variables.

Results: All patients (100%) received multiple audiological assessments, with 21 (55.3%) receiving baseline assessment. The mean hearing deterioration at pure-tone average 1-2-4 kHz was mild (range 22.4-27.6 dB). However, clinically significant SNHL was evident in 37 (97.3%), 24 (63.2%), and 14 (36.8%) patients at 8 kHz and pure-tone averages 0.5-1-2 kHz and 1-2-4 kHz, respectively. Principal component analysis indicated two profiles: (1) low or medium frequency SNHL and (2) high-frequency SNHL. Multivariate analysis demonstrated tobacco consumption (ρ < 0.006) and alcohol intake (ρ < 0.08) predicted high-frequency SNHL (F(3,33) = 3.59, ρ < 0.02, R² = 0.177), with cumulative cisplatin dose (ρ < 0.006) predicting low and medium frequency SNHL (F(3,34) = 14.81, ρ < 0.001, R² = 0.528).

Conclusions: Although hearing loss rates may be under reported without routine audiological assessment, the incidence of cisplatin-based chemoradiation-induced SNHL, in this study, is high. The proposed predictive model can be used as a prognostic tool and potentially mitigate adverse outcomes.

Keywords: head and neck cancer; medical oncology; patient quality of life; radiation oncology; sensorineural hearing loss.