PATTERNS OF HEARING-LOSS RESULTING FROM CISPLATINUM THERAPY

The purpose of this study was to provide a clinically useful classific ation of the hearing loss that occurs with chemotherapy using cis-diam minedichloroplatinum (cis-platinum). Serial audiometric testing was pe rformed on 66 patients who underwent cis-platinum chemotherapy (2 to 6 courses, 100 mg/m2). Subsequent hearing losses were classified accord ing to (1) whether hearing loss occurred after the first or second cou rse of chemotherapy, (2) the magnitude of loss, and (3) the frequencie s affected. Of 39 patients who could be classified, 21 (54%) had no lo ss or mild loss, 14 (36%) had early loss, and 4 (10%) had late loss. D ifferent patterns of hearing loss were observed. The observation that different patterns of hearing loss occur implies that different mechan isms of hearing loss exist. Some mechanisms must be more important in different patients. Our data are important with regard to continuation of chemotherapy treatment after hearing loss occurs. Most significant hearing loss (90%) occurred early or not at all. If early hearing los s occurred and treatment was continued, the speech frequencies were ev entually affected in 71% of patients. Recognition of the patterns of h earing loss are important considerations when discontinuation of thera py is being considered.