Ototoxicity and cancer therapy

Cancer. 2016 Jun 1;122(11):1647-58. doi: 10.1002/cncr.29779. Epub 2016 Feb 9.

Abstract

Ototoxicity is a well-established toxicity associated with a subgroup of antineoplastic therapies that includes platinum chemotherapy, radiation or surgery involving the ear and auditory nerve, and supportive care agents such as aminoglycoside antibiotics and loop diuretics. The reported prevalence of ototoxicity in patients who have received potentially ototoxic therapy ranges from 4% to 90% depending on factors such as age of the patient population, agent(s) used, cumulative dose, and administration techniques. The impact of ototoxicity on subsequent health-related and psychosocial outcomes in these patients can be substantial, and the burden of morbidity related to ototoxic agents is particularly high in very young children. Considerable interindividual variability in the prevalence and severity of ototoxicity has been observed among patients receiving similar treatment, suggesting genetic susceptibility as a risk factor. The development and testing of otoprotective agents is ongoing; however, to the author's knowledge, no US Food and Drug Administration-approved otoprotectants are currently available. Prospective monitoring for ototoxicity allows for comparison of auditory outcomes across clinical trials, as well as for early detection, potential alterations in therapy, and auditory intervention and rehabilitation to ameliorate the adverse consequences of hearing loss. Cancer 2016;122:1647-58. © 2016 American Cancer Society.

Keywords: antineoplastic therapy; genetic predisposition; grading scales; management of hearing loss; otoprotection; ototoxicity.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Antineoplastic Agents / adverse effects*
  • Ear / anatomy & histology
  • Ear / physiology
  • Ear / radiation effects
  • Ear Diseases / epidemiology
  • Ear Diseases / etiology*
  • Ear Diseases / prevention & control
  • Genetic Predisposition to Disease
  • Hearing Loss / epidemiology
  • Hearing Loss / etiology
  • Hearing Loss / therapy
  • Humans
  • Medical Illustration
  • Neoplasms / therapy*
  • Postoperative Complications / etiology*
  • Postoperative Complications / prevention & control
  • Prevalence
  • Radiation Injuries / complications
  • Radiation Injuries / prevention & control
  • Radiotherapy / adverse effects*
  • Tinnitus / epidemiology
  • Tinnitus / etiology
  • Vertigo / epidemiology
  • Vertigo / etiology

Substances

  • Antineoplastic Agents