Trends in ototoxicity monitoring among cisplatin-treated patients with cancer
Menée à partir de données portant sur 955 patients atteints d'un cancer traité par cisplatine, cette étude de cohorte rétrospective analyse les modalités de prise en charge des toxicités auditives induites par le traitement anticancéreux et identifie les facteurs entravant un suivi auditif
Purpose: This study aims to characterize patterns in ototoxicity monitoring and identify potential barriers to audiologic follow-up. Methods: We performed a single-institution retrospective cohort study on adult (≥ 18 years old) cancer patients treated with cisplatin from January 2014 to September 2021. Our primary outcomes were rates of baseline and post-treatment audiograms at the following time points: 3, 6, 12, and greater than 12 months. Time-to-event analyses were performed to describe additional insights to ototoxicity monitoring patterns. Results: Nine hundred fifty-five patients with cancer were included for analysis. The most common primary cancer sites were head and neck (64%), followed by cervical (24%). Three hundred seventy-three patients (39%) underwent baseline audiometric assessment, 38 patients (4%) received audiologic evaluation during chemotherapy, and 346 patients (36%) obtained at least one post-treatment audiogram. Audiologic follow-up was greatest within 3 months of completing chemotherapy (26%), but this tapered dramatically to less than 10% at every other post-treatment time point. Patients with head and neck cancer achieved higher rates of audiologic follow-up at every time point than patients with non–head and neck cancer except for during treatment. Conclusions: Ototoxicity monitoring is an inconsistent practice, particularly during chemotherapy and for long-term surveillance of hearing loss. Patients with non–head and neck cancer may be at increased risk for loss of audiologic follow-up. Implications for Cancer Survivors: Cisplatin ototoxicity is a common occurrence that can be effectively managed with auditory rehabilitation. Therefore, referrals to audiology and counseling on treatment-related ototoxicity are recommended throughout chemotherapy and cancer survivorship.