Time course and clinical characterization of cisplatin-induced ototoxicity after treatment for nasopharyngeal carcinoma in a South East Asian population

Background: The purpose of this study was to characterize the clinical course of hearing loss in patients with nasopharyngeal carcinoma (NPC) and the clinical factors affecting its severity. Methods: The time course of hearing loss in patients with NPC was assessed using threshold shift from baseline and Common Terminology Criteria for Adverse Events (CTCAE) grade. Results: In the chemoradiotherapy (CRT) groups, the threshold shift was significantly higher from 3 months at 4 kHz (P52.3031029, concurrent CRT only) but not within 2 years posttreatment in the radiotherapy (RT) group. The CRT groups had worse CTCAE grades than the RT group (percentage of latest CTCAE grade similar to 1: 64.9% vs 29.0%, respectively). Cumulative cisplatin dose and cochlear RT dose significantly affects threshold shifts, especially at high frequencies. Conclusion: Although cisplatin led to high frequency hearing impairment from about 3 months posttreatment, RT conferred no significant hearing impairment in the first 2 years.