Factors influencing ototoxicity in ovarian cancer patients treated with Cis-platinum based chemotherapy

Seventy-seven ovarian cancer patients were evaluated for auditory toxicity following low-dose, slow-infusion cisplatin therapy. Twenty patients had baseline normal hearing with conventional audiological assessment of pure tone sensitivity at 250 to 8,000 Hz prior to therapy, along with at least one repeated audiogram before subsequent treatments. Ten of these patients also had serial assessment of ultra-high frequencies (10,000 to 18,000 Hz). Six of the 20 patients (30%) developed pure tone threshold elevations of at least 10 dB in any two frequencies. This hearing loss was predominantly persistent, bilateral, symmetrical, and above the speech range. Hearing loss was categorically mild and not statistically significant, at any specific frequencies. Hearing loses were not progressive with repeated doses of cisplatin. Only one of 20 patients reported tinnitus, and no vestibular toxicity was observed. One patient complained of clinically significant hearing difficulty. The risk of developing hearing loss appeared significant for patients older than 42 years, but failed to correlate statistically with disease stage at diagnosis, cumulative cisplatin dosage, or the presence of other ototoxic drugs (furosemide and IV aminoglycosides). The relationship between nephrotoxicity and ototoxicity in this study was inconclusive.