Audiometric monitoring of cis-platinum ototoxicity

A prospective study was performed on 37 patients receiving 50 mg/m2 of cis-platinum every 3 to 4 weeks. These patients received a baseline audiogram evaluation and subsequent testing before each dose. Ototoxicity was noted to occur in 46% of the patients during therapy. Fourteen percent of this group showed a hearing loss in the speech frequency range. Four variables were analyzed to determine their correlative value for subsequent ototoxicity: (i) Pretreatment (baseline) audiograms, (ii) cumulative dose in milligrams, (iii) dosage in milligrams per square meter, and (iv) mean serum creatinine. Of these parameters, only a pretreatment abnormal audiogram was shown to have a prognostic value at a level of P = 0.095. Recommendations for audiometric monitoring of this high-risk group are discussed.