Older patients had hearing loss at lower chemotherapy doses
An observational study of 316 people with head and neck cancer tracked hearing during treatment with cisplatin, a chemotherapy drug.
Cancer Medicine
Researchers retrospectively analysed records from 316 patients with head and neck cancer who received cisplatin chemotherapy between January 2009 and June 2023. This observational study tracked hearing as patients accumulated doses, using hearing tests and measurements of sounds produced by the inner ear.
Older patients already had poorer high-frequency hearing before chemotherapy. Higher total cisplatin doses were associated with worsening hearing across all age groups. Older patients developed clinically relevant hearing impairment at lower total doses than younger patients, despite smaller measured changes. The researchers attributed this pattern to older patients’ poorer starting hearing, which left less capacity to withstand further loss. Younger patients started with better hearing, leaving more room for measurable change; their larger changes did not indicate greater vulnerability.
Why it matters
Poorer hearing at older ages poses a challenge for monitoring cancer care. The authors called for age-adapted hearing monitoring and treatment planning that considers total cisplatin dose.
Caveats
This retrospective observational study could identify associations, not establish cause and effect. It involved patients with head and neck cancer at one tertiary cancer centre.
- Cumulative cisplatin exposure
- Radiotherapy
- Head and neck cancer
- Cisplatin-induced ototoxicity
- Distortion product otoacoustic emissions
- Humans