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Prevention and treatment of cisplatin-induced ototoxicity in adults: A systematic review
Juan Esteban Correa-Morales1,2, Sara Giraldo-Moreno3, Nidia Mantilla-Manosalva1,2
1Palliative Care Program, Universidad de La Sabana, Bogotá, Colombia.
Objectives:
Ototoxicity is a common disabling side effect of platinum-based chemotherapy. This study aimed to assess the evidence on the management of platinum-induced ototoxicity in adult cancer patients.
Methods:
Four databases were searched up to 1 November 2022. Original studies were included if they reported on a pharmacologic or non-pharmacologic intervention to prevent or treat platinum ototoxicity in adults. The articles' quality was assessed via two grading scales.
Results:
Nineteen randomised controlled trials and five quasi-experimental studies with 1673 patients were analysed. Eleven interventions were identified, nine pharmacological and two non-pharmacological. Six of the interventions (sodium thiosulphate, corticoids, sertraline, statins, multivitamins and D-methionine) showed mild benefits in preventing cisplatin-induced ototoxicity. Only one trial assessed corticoids as a potential treatment. Overall, only six trials were deemed with a low risk of bias. The majority of studies inadequately documented intervention-related adverse effects, thereby limiting safety conclusions.
Conclusions:
Current interventions have mild benefits in preventing cisplatin-induced ototoxicity in adult cancer patients. Sodium thiosulphate is the most promising intervention as a preventive strategy. Rigorous, high-quality research is warranted, encompassing an evaluation of all potential symptoms and innovative treatment modalities.
Insights
Platinum-based chemotherapy can cause ototoxicity, or hearing damage. While some interventions show mild benefits in preventing this side effect, sodium thiosulphate appears most promising for cancer patients.
Area of Science:
- Oncology
- Pharmacology
- Ototoxicology
Background:
- Platinum-based chemotherapy is a cornerstone in cancer treatment but frequently causes ototoxicity, a disabling side effect impacting patient quality of life.
- Managing platinum-induced ototoxicity is crucial for improving treatment adherence and patient outcomes in adult cancer care.
Approach:
- A systematic review of original studies was conducted, searching four databases up to November 2022.
- Included studies reported on pharmacologic or non-pharmacologic interventions for preventing or treating platinum ototoxicity in adults.
- Study quality was assessed using established grading scales, with a focus on risk of bias and adverse event reporting.
Key Points:
- Eleven interventions were identified, including nine pharmacological and two non-pharmacological.
- Six interventions (sodium thiosulphate, corticoids, sertraline, statins, multivitamins, D-methionine) demonstrated mild benefits in preventing cisplatin-induced ototoxicity.
- Only six of the analyzed trials had a low risk of bias, and safety data was often insufficient.
Conclusions:
- Current interventions offer limited efficacy in preventing platinum-induced ototoxicity in adult cancer patients.
- Sodium thiosulphate emerges as the most promising agent for ototoxicity prevention.
- High-quality research is essential to evaluate novel treatment modalities and comprehensively assess safety profiles.
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