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Cochleovestibular toxicity related to dichloromethotrexate
L Golden1, J D Ahlgren, J Kattah
1Department of Surgery, Vincent T. Lombardi Cancer Research Center, Washington, D.C.
Cancer Investigation
|January 1, 1989
Summary
Dichloromethotrexate (DCM), a lung cancer drug, can cause significant hearing loss and vestibular problems. This ototoxicity may occur even with monotherapy, highlighting the need for careful patient monitoring.
Area of Science:
- Oncology
- Ototoxicology
- Neuroscience
Background:
- Lung cancer treatment often involves chemotherapy with potential side effects.
- Dichloromethotrexate (DCM) is used as a monotherapy for lung cancer.
- Ototoxicity is a known risk associated with certain chemotherapy agents.
Observation:
- A 69-year-old man on DCM monotherapy developed severe cochleovestibular dysfunction.
- Initial symptoms included vestibular issues, followed by progressive unilateral hearing loss.
- Hearing loss persisted and worsened (80 dB low frequency, 40 dB high frequency) even after discontinuing DCM.
Findings:
- Dichloromethotrexate (DCM) demonstrated significant ototoxic potential in a patient receiving monotherapy.
- The drug induced both vestibular and auditory damage, with hearing loss progressing post-cessation.
- This case suggests DCM can be an ototoxin independent of other chemotherapeutic agents.
Implications:
- DCM should be considered a potential ototoxin in lung cancer patients.
- Careful audiological and vestibular monitoring is crucial for patients on DCM.
- The ototoxic potential of DCM warrants consideration, especially when used in combination with other ototoxic drugs like cisplatin.
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