Cancer survivors and neurotoxic chemotherapy: hearing loss and tinnitus

Abstract

Objectives: Little is known about hearing loss and tinnitus associated with neurotoxic chemotherapy. Study evaluated for differences in occurrence rates and effects of hearing loss and tinnitus in survivors who received a platinum alone, a taxane alone or a platinum and taxane containing regimen.

Methods: Total of 273 survivors with breast, gastrointestinal, gynaecological or lung cancer completed self-report measures of hearing loss and tinnitus and had an audiometric assessment that obtained pure tone air conduction thresholds bilaterally at frequencies of between 0.25 kHz to 16.0 kHz. To adjust for age-related and gender-related changes in hearing, each survivor's audiogram was evaluated using the National Health and Nutrition Examination Survey-modified Occupational Safety and Health Administration standards. Survivor was classified as having hearing loss if at any frequency they scored poorer than the 50th percentile for their age and gender. Survivors were categorised as having tinnitus if they reported that for >10% of their time awake, they were consciously aware of their tinnitus. Differences among the chemotherapy groups were evaluated using parametric and non-parametric tests.

Results: For most of the demographic and clinical characteristics, no differences were found among the three chemotherapy groups. Occurrence rates for audiogram-confirmed hearing loss ranged from 52.3% to 71.4%. Occurrence rates for tinnitus ranged from 37.1% to 40.0%. No differences were found among the three chemotherapy groups in the occurrence rates or effects of hearing loss and tinnitus.

Conclusion: These findings suggest that regardless of the chemotherapy regimen common mechanistic pathway(s) may underlie these two neurotoxicities.

Keywords: Cancer; Clinical assessment; Supportive care; Survivorship; Symptoms and symptom management.

Figure 1A –

Differences in the percentage of survivors who self-reported hearing loss across the three chemotherapy regimens (p=0.861).

Figure 1B –

Differences in the percentage of survivors with audiogram-confirmed hearing loss across the three chemotherapy regimens (p=0.104).

Figure 2A –

Differences in the percentage of survivors who self-reported tinnitus across the three chemotherapy regimens (p=0.707).

Figure 2B –

Differences in the percentage of survivors with tinnitus defined as the occurrence of tinnitus being present at least 5 minutes per day for 4 days per week across the three chemotherapy regimens (p=0.951).