Age-Dependent Patterns of Cisplatin-Induced Ototoxicity in Head and Neck Cancer: A Longitudinal Audiologic Analysis

Background

Cisplatin (CDDP) is a key chemotherapeutic agent used to treat head and neck cancer. Improved survival rates have increased concerns about CDDP-induced ototoxicity, as this toxicity significantly impacts survivors' quality of life. However, the dose-dependent and age-related patterns of CDDP-induced ototoxicity remain incompletely defined. Therefore, in this study, we aimed to characterize CDDP-induced ototoxicity by tracking longitudinal hearing data and evaluating the associated factors. Patients and methods: We retrospectively analyzed a cohort of 316 patients with head and neck cancer who received CDDP-based chemotherapy at a tertiary cancer center between January 2009 and June 2023. Hearing function was longitudinally assessed using pure-tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE) across the cumulative CDDP dose. Multivariate logistic regression analyses were performed to identify the factors associated with ototoxicity, including the cumulative dose, age, radiotherapy, and the primary tumor site.