[Auditory assessment in a protocol of concurrent carboplatin and irradiation use in fractionated therapy]

Possible ototoxicity related with a hyperfractionated concurrent chemo-radiation schedule was studied in 36 patients with head and neck cancer. The schedule consisted of two daily fractions, each consisting of 5 mg/m2 of carboplatin plus 115 cGy. Therapy was given 5 days a week for 7 weeks up to a total dose of 700 mg carboplatin and 8050 cGy. Tonal audiograms and superliminal tests were carried out before treatment, at conclusion, six months post-treatment, and every year thereafter. After a mean follow-up of 18 months (maximum 30 months), no treatment-related sensorineural hearing loss was observed. However, recruitment disappeared in post-treatment superliminal tests in 37% of patients who presented sensorineural deafness with recruitment, although it reappeared in audiograms recorded six months later. We attributed this to transient demyelinization. After treatment, a previous tympanosclerosis reactivated in 1 case and effusive otitis media occurred in 8 patients. Previous effusive otitis media disappeared in 1 patient (nasopharyngeal tumor).