Ototoxicity in locally advanced head and neck cancer patients treated with induction chemotherapy followed by intermediate or high-dose cisplatin-based chemoradiotherapy

Head Neck. 2019 Feb;41(2):488-494. doi: 10.1002/hed.25434. Epub 2018 Dec 7.

Abstract

Background: This study evaluated ototoxicity in locally advanced head and neck cancer patients treated in the CONDOR study with docetaxel/cisplatin/5-fluorouracil (TPF) followed by conventional radiotherapy with concomitant cisplatin 100 mg/m2 on days 1, 22, and 43 (cis100+RT) versus accelerated radiotherapy with concomitant cisplatin weekly 40 mg/m2 (cis40+ART).

Methods: Sixty-two patients were treated in this study. Audiometry was performed at baseline, during TPF, before start of chemoradiotherapy, and 1, 4, 8, and 12 months after treatment.

Results: A complete dataset of audiometric data was available of 12 patients treated with high-dose cisplatin and of 11 patients treated with intermediate-dose cisplatin. Patients in the high-dose group showed significant more hearing loss than in the intermediate group at 4 kHz ([z = 1.98; P = .04] and 8 kHz [z = 2.07; P < .03]). Interindividual variation was high in both groups.

Conclusion: After induction TPF, more ototoxicity was observed in chemoradiotherapy with cis100+RT than after chemoradiotherapy with cis40+ART.

Keywords: chemoradiotherapy; cisplatin; high dose; intermediate dose; ototoxicity.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols
  • Chemoradiotherapy*
  • Cisplatin / therapeutic use*
  • Docetaxel / therapeutic use
  • Female
  • Fluorouracil / therapeutic use
  • Head and Neck Neoplasms / drug therapy*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy
  • Humans
  • Induction Chemotherapy*
  • Male
  • Middle Aged
  • Netherlands
  • Ototoxicity / diagnosis
  • Ototoxicity / epidemiology*

Substances

  • Antineoplastic Agents
  • Docetaxel
  • Cisplatin
  • Fluorouracil