Cisplatin administration to gynecologic cancer patients. Long-term effects on hearing

Cisplatin is known to create an acute dose-related ototoxic effect. There are unanswered questions regarding the long term effect of cisplatin on hearing in gynecologic cancer patients.

A retrospective review of 59 to 115 months' duration was performed on 184 women with gynecologic cancer who were treated with cisplatin-based chemotherapy between 1982 and 1986. Twenty-six of 40 survivors were again tested audiometrically with the same audiologic equipment.

Fourteen patients (54%) had significantly progressive hearing loss (> or = 15 decibels) at long term follow-up compared with the posttreatment control. These changes were generally small and restricted to three frequencies or fewer in one of the patient's ears. The changes corresponded to the expected age effect upon hearing. Only 2 patients (8%) showed more severe hearing threshold changes. The hearing loss in one of the two patients might represent degenerative changes induced by cisplatin treatment, whereas in the other patient the etiologic background to the hearing loss remains unknown.

This study does not provide any strong evidence for a delayed ototoxic effect of cisplatin that should influence therapeutic strategy. Patients who receive moderate dose cisplatin therapy, 50 mg/m2 per body surface area every 4 weeks, have a negligible long term risk of a drug-induced social hearing handicap.