Kalyanam Balamurali, Sarala N, Azeem Mohiyuddin S M, Diwakar Ravi
Department of Pharmacology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.
Department of Otolaryngology and Head and Neck Surgery, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.
J Cancer Res Ther. 2018 Jul-Sep;14(5):1099-1104. doi: 10.4103/0973-1482.188426.
Cisplatin is one of the anticancer drugs used for head and neck cancers. Although some studies have shown that cisplatin can cause ototoxicity, periodic audiometric assessments have not been extensively studied in the Indian rural population. Hence, this study has been undertaken to evaluate the effects of cisplatin on hearing.
Fifty-nine patients with squamous cell carcinomas of head and neck, who received cisplatin chemotherapy, were recruited. Serum creatinine, blood urea, serum proteins, and audiometry were assessed before and after the first, second, and third chemotherapy cycle. The cochleotoxic effect of cisplatin was assessed by pure tone audiometry. Hearing loss was graded accordingly. All patients were administered a quality of life questionnaire at baseline and at the end of the third cycle.
Hearing loss was observed in 12 patients at speech frequencies and those at higher frequencies were 12 (4000 Hz), 18 (6000 Hz), and 28 (8000 Hz). The hearing loss was symmetrical, sensorineural, and showed a strong correlation with the low serum albumin levels at the end of the third cycle. Dizziness was seen in eight patients, at the end of the study. The commonly observed adverse effects were nausea, vomiting, hair loss, fatigue, and tinnitus.
The studies have shown hearing loss in higher frequencies, but in our study, we have observed hearing loss at speech frequency in 22.2% of patients receiving cisplatin, who also had low serum albumin levels. Periodic audiometric monitoring and serum albumin level may be helpful to provide timely intervention to prevent further hearing loss and deterioration in the quality of life.
顺铂是用于治疗头颈癌的抗癌药物之一。尽管一些研究表明顺铂可导致耳毒性，但在印度农村人口中，定期听力测定评估尚未得到广泛研究。因此，开展本研究以评估顺铂对听力的影响。
招募了59例接受顺铂化疗的头颈鳞状细胞癌患者。在第一个、第二个和第三个化疗周期之前及之后评估血清肌酐、血尿素、血清蛋白和听力测定。通过纯音听力测定评估顺铂的耳蜗毒性作用。相应地对听力损失进行分级。所有患者在基线时和第三个周期结束时接受生活质量问卷调查。
在言语频率处观察到12例患者有听力损失，在较高频率处有听力损失的患者分别为12例（4000Hz）、18例（6000Hz）和28例（8000Hz）。听力损失是对称的、感音神经性的，并且与第三个周期结束时的低血清白蛋白水平密切相关。在研究结束时，8例患者出现头晕。常见的不良反应有恶心、呕吐、脱发、疲劳和耳鸣。
研究表明在较高频率处有听力损失，但在我们的研究中，我们观察到在接受顺铂治疗的患者中，22.2%在言语频率处有听力损失，这些患者血清白蛋白水平也较低。定期听力测定监测和血清白蛋白水平可能有助于提供及时干预，以防止听力进一步丧失和生活质量恶化。
