CISPLATIN ADMINISTRATION TO GYNECOLOGIC CANCER-PATIENTS - LONG-TERM EFFECTS ON HEARING

BACKGROUND. Cisplatin is known to create an acute dose-related ototoxi c effect. There are unanswered questions regarding the long term effec t of cisplatin on hearing in gynecologic cancer patients. METHODS. A r etrospective review of 59 to 115 months' duration was performed on 184 women with gynecologic cancer who were treated with cisplatin-based c hemotherapy between 1982 and 1986. Twenty-six of 40 survivors were aga in tested audiometrically with the same audiologic equipment. RESULTS. Fourteen patients (54%) had significantly progressive hearing loss (g reater than or equal to 15 decibels) at long term follow-up compared w ith the posttreatment control. These changes were generally small and restricted to three frequencies or fewer in one of the patient's ears. The changes corresponded to the expected age effect upon hearing. Onl y 2 patients (8%) showed more severe hearing threshold changes; The he aring loss in one of the two patients might represent degenerative cha nges induced by cisplatin treatment, whereas in the other patient the etiologic background to the hearing loss remains unknown. CONCLUSIONS. This study does not provide any strong evidence for a delayed ototoxi c effect of cisplatin that should influence therapeutic strategy. Pati ents who receive moderate dose cisplatin therapy, 50 mg/m(2) per body surface area every 4 weeks, have a negligible long term risk of a drug -induced social hearing handicap. (C) 1996 American Cancer Society.