Summary
Purpose: To assess the effect of cisplatin (CDDP) plus concurrent radiation therapy on hearing loss. Methods: 451 patients with glioblastoma multiforme (GBM) were randomly assigned after surgery to: Arm A: Carmustine (BCNU) + standard radiation therapy (SRT); Arm B: BCNU + accelerated radiation therapy (ART: 160 cGy twice daily for 15 days); Arm C: CDDP + BCNU + SRT; or Arm D: CDDP + BCNU + ART. Patients on arms C and D received audiograms at baseline, and prior to the start of RT, and prior to cycles 3 and 6. Otologic toxicities were recorded at each visit. Results: 56% of patients had hearing loss at baseline. 13% and 50% of patients experienced worsening ototoxicity after 1 year of treatment in arms A and B vs. C and D, respectively, with 13% of those on arms C and D experiencing significant ototoxicity (≥ grade 3) at 6 months. Increasing age was associated with an increased risk of ototoxicity. Conclusions: Increased exposure to CDDP increases the risk of ototoxicity over time. Older patients are more susceptible to hearing loss with CDDP. The low proportion of patients with clinically significant ototoxicity suggests that baseline screening is unnecessary in GBM patients.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Moroso MJ, Blair RL, A review of cis-platinum ototoxicityJ Otolaryngol 1983;12(6):365–369
Boheim K, Bichler E, Cisplatin-induced ototoxicity: audiometric findings and experimental cochlear pathologyArch Otorhinolaryngol 1985;242(1):1–6
Schaefer SD, Post JD, Close LG, Wright CG: Ototoxicity of low- and moderate-dose cisplatinCancer 1985;56(8):1934–1939
Hinojosa R, Riggs LC, Strauss M, Matz GJ. Temporal bone histopathology of cisplatin ototoxicityAm J Otolaryng 1995;16(6):731–740
Hoistad DL, Ondrey FG, Mutlu C, Schachern PA, Paparella MM Adams GL. Histopathology of human temporal bone after cis-platinum, radiation, or bothOtolaryngol Head Neck Surg 1998;118(6):825–832
Kwong DL, Wei WI, Sham JS, Ho WK, Yuen PW, Chua DT, Au DK, Wu PM, Choy DT. Sensorineural hearing loss in patients treated for nasopharyngeal carcinoma. A prospective study of the effect of radiation and cisplatin treatmentInt J Radiat Oncol Biol Phys 1996;36:281–289
Anteunis LJ, Wanders SL, Hendriks JT, Langendijk JA, Manni JJ, de Jong JM. A Prospective Longitudinal Study on Radiation-Induced Hearing LossAm J Surg 1994;168:408–411
Kretschmar CS, Warren MP, Lavally BL, Dyer S, Tarbell NJ. Ototoxicity of preradiation cisplatin for children with central nervous system tumorsJ Clin Oncol 1990;8:1191–1198
Schell MJ, McHaney VA, Green AA, Kun LE, Hayes FA, Horowitz M, Meyer WH. Hearing loss in children and young adults receiving cisplatin with or without prior cranial irradiationJ Clin Oncol 1989;7:754–760
Stewart JD, O’Bryan RM, Al-Sarraf M, Al-Sarraf M, Costanzi JJ, Oishi N. Phase II study of cisplatin in recurrent astrocytomas in adults: a Southwest Oncology Group StudyJ Neurooncol 1983;1:145–147
Stewart DJ, Mikhael NZ, Nair RC, Kacew S, Montpetit V, Nanji A, Maroun JA, Howard K. Platinum concentrations on human autopsy tumor samplesAm J Clin Oncol 1988;11:152–158
Douple EB, Keynote address: platinum-radiation InteractionsNCI Monograph 1988;6:315–319
Miettinen S, Laurikainen E, Johansson R, Minn H, Laurell G, Salmi TT. Radiotherapy enhanced ototoxicity of cisplatin in childrenActa Otolaryngol (Stockh) 1997;529(Suppl):90–94
Buckner JC, Michalak JC, Schomberg PJ, Burton GV, Sandler HM, Cascino TL, Hawkins RB, Scheithauer BW, O'Fallon JR. Phase III trial of BCNU plus cisplatin (CDDP) versus BCNU alone, and standard radiation therapy (SRT) versus accelerated radiation therapy (ART) in glioblastoma (GMB) patients (Pts): NCCTG/SWOG results. [Abstract 219] Proc Amer Soc Clin Oncol 2001;20:56a
Kaplan EL, Meier P, Non-parametric estimation from incomplete observationsJ Am Stat Assoc 1958;3:457–481
Peto R, Peto J, Asymptotically efficient rank invariant procedures (with discussion) J Roy Stat Soc (Series A) 1972;135:185–207
Andersen PK, Gill RD, Cox’s regression model for counting processes: a large sample studyAnn Stat 1982;10:1100–1120
Nagy JL, Adelsten DJ, Newman CW, Rybicki LA, Rice TW, Lavertu, P. Cisplatin ototoxicity: the importance of baseline audiometryAm J Clin Oncol 1999;22(3):305–308
Kujansuu E, Rahko T, Punnonen R, Karma P. Evaluation of the hearing loss associated with cis-platinum treatment by high-frequency audiometryGynecol Oncol 1989;33(3):321–322
Blakley BW, Gupta AK, Myers SF, Schwan S. Risk factors for ototoxicity due to cisplatinArch Otolaryngol Head Neck Surg 1994;120:541–546
Brown RL, Nuss RC, Patterson R, Irey J. Audiometric monitoring of cis-platinum ototoxicityGynecol Oncol 1983;16:254–262
Durrant JD, Rodgers G, Myers EN, Johnson JT. Hearing loss – risk factor for cisplatin ototoxicity? ObservationsAm J Otol 1990;11:375–377
Acknowledgements
This study was conducted as a collaborative trial of the North Central Cancer Treatment Group and Mayo Clinic and was supported in part by Public Health Service Grant CA-25224, CA-37404, CA-15083, CA-63826, CA-35103, and the National Fellowship Academic Medicine Fellowship. The authors would like to thank Drs. Christopher Bacch and Charles Beatty for their advice (Department of Otorhinolaryngology. Magoclinic, Rochester, MN).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Marshall, N.E., Ballman, K.V., Michalak, J.C. et al. Ototoxicity of cisplatin plus standard radiation therapy vs. accelerated radiation therapy in glioblastoma patients. J Neurooncol 77, 315–320 (2006). https://doi.org/10.1007/s11060-005-9049-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11060-005-9049-1