Department of Otolaryngology, Head and Neck Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Laryngoscope. 2020 Sep;130(9):E515-E521. doi: 10.1002/lary.28543. Epub 2020 Feb 17.
Cisplatin-related hearing loss (HL) is claimed to progress after treatment. This controlled longitudinal study with extended follow-up investigates HL in testicular cancer survivors (TCSs) after cisplatin-based chemotherapy (CBCT).
Controlled longitudinal study.
Eighty-two TCSs treated with CBCT between 1980 and 1994 in Norway participated in two surveys (S1/S3), including pure-tone audiograms (0.125-8 kHz) and self-reported HL, 12 and 31 years after treatment, respectively. Hearing thresholds were age-adjusted based on age-matched hearing thresholds from the general population (controls). Hearing loss was defined as thresholds >20 dB at any frequency.
Between the two surveys, the prevalence of high-frequency HL (4, 6, and 8 kHz) increased from 73% to 94% but approached those of the aging general population after age adjustment. In TCSs aged >40 years at first survey, HL at the subsequent survey equaled that of controls. Self-reported HL increased from seven (9%) at S1 to 20 (26%) at S3. At S1, age-adjusted HL was identified in all (seven) TCSs reporting decreased hearing whereas at S3, hearing thresholds did not differ from controls in seven out of 20 patients reporting HL.
CBCT-related ototoxicity causes high-frequency HL, but in contrast to reports from follow-up studies from the first post-treatment decade, no major progression was found beyond the first post-treatment decade for frequencies 0.125-8 kHz. Importantly, with extended follow-up, hearing thresholds of patients approach those of the general population, possibly due to a less-than-additive effect with age-related hearing loss (ARHL) in CBCT-treated patients. Age-and sex-matching is strongly advised in long-term follow-up of CBCT-related ototoxicity. Specificity for detecting ototoxicity with self-reported questionnaires decreases with extended follow-up.
3 Laryngoscope, 130:E515-E523, 2020.
顺铂相关性听力损失（HL）据称在治疗后会进展。本项经扩展随访的对照性纵向研究调查了接受顺铂为基础的化疗（CBCT）治疗后的睾丸癌幸存者（TCS）的 HL。
对照性纵向研究。
1980 年至 1994 年在挪威接受 CBCT 治疗的 82 例 TCS 参与了两项调查（S1/S3），分别在治疗后 12 年和 31 年时进行纯音测听（0.125-8 kHz）和自我报告的 HL。听力阈值基于年龄匹配的一般人群（对照组）的听力阈值进行年龄调整。将任何频率的听力阈值>20 dB 定义为听力损失。
在两次调查之间，高频 HL（4、6 和 8 kHz）的患病率从 73%增加到 94%，但在年龄调整后接近老龄化一般人群的患病率。在首次调查时年龄>40 岁的 TCS 中，随后的调查中 HL 与对照组相同。自我报告的 HL 从 S1 时的 7 例（9%）增加到 S3 时的 20 例（26%）。在 S1 时，在报告听力下降的所有（7 例）TCS 中均发现了年龄调整后的 HL，而在 S3 时，在报告 HL 的 20 例患者中，有 7 例的听力阈值与对照组无差异。
CBCT 相关性耳毒性导致高频 HL，但与治疗后第一个十年的随访研究报告相反，在治疗后第一个十年之后，0.125-8 kHz 的频率并未发现明显进展。重要的是，随着随访时间的延长，患者的听力阈值接近一般人群，这可能是由于 CBCT 治疗患者的听力损失（ARHL）与年龄相关的听力损失具有非累加效应。在 CBCT 相关性耳毒性的长期随访中强烈建议进行年龄和性别匹配。随着随访时间的延长，自我报告问卷检测耳毒性的特异性会降低。
3.喉镜，130：E515-E523，2020 年。
