Research

High prevalence of cisplatin-induced ototoxicity in Cape Town, South Africa

Heather Whitehorn, Mkhonzeni Sibanda, Miguel Lacerda, Timothy Spracklen, Lebogang Ramma, Sameera Dalvie, Raj Ramesar

Abstract


Background. Cisplatin is administered as the first-line treatment of soft-tissue cancers. It has a reported cure rate of up to 85%, but is associated with a high incidence of ototoxicity, characterised by irreversible bilateral hearing loss and affecting 23 - 50% of adults who receive the drug.

Objectives. To determine the incidence of cisplatin-induced ototoxicity at Groote Schuur Hospital (GSH), Cape Town, South Africa.

Methods. A retrospective cross-sectional study of cisplatin-receiving cancer patients attending GSH between January 2006 and August 2011.

Results. A total of 377 patients were recorded as receiving cisplatin therapy during the study period. A 300% increase in new cisplatin-receiving patients receiving audiological monitoring was observed between 2006 and 2010. However, only patients with all clinical data as well as baseline and follow-up audiometric analyses were investigated. One hundred and seven such patients were identified, 55.1% of whom developed cisplatin-induced ototoxicity while receiving high-dose (≥60 mg/m2) cisplatin treatment. Higher cumulative cisplatin dosages were associated with development of significant hearing loss (p=0.027). The odds of developing cisplatin-induced hearing loss were elevated for patients with head and neck tumours and lymphoma (p=0.0465 and p=0.0563, respectively) and were significantly lower for those with reproductive cancers (p=0.0371).

Conclusion. Comprehensive audiological monitoring should be available for every patient during cisplatin treatment to minimise the development of disabling hearing loss.


Authors' affiliations

Heather Whitehorn, Division of Human Genetics, Department of Clinical Laboratory Sciences, Faculty of Health Sciences, University of Cape Town, South Africa

Mkhonzeni Sibanda, Division of Communication Sciences and Disorders, Groote Schuur Hospital, Cape Town, South Africa

Miguel Lacerda, Department of Statistical Sciences, Faculty of Science, University of Cape Town, South Africa

Timothy Spracklen, Division of Human Genetics, Department of Clinical Laboratory Sciences, Faculty of Health Sciences, University of Cape Town, South Africa

Lebogang Ramma, Division of Communication Sciences and Disorders, Groote Schuur Hospital, Cape Town, South Africa

Sameera Dalvie, Department of Radiation Oncology, Groote Schuur Hospital, Cape Town, South Africa

Raj Ramesar, Division of Human Genetics, Department of Clinical Laboratory Sciences, Faculty of Health Sciences, University of Cape Town, South Africa

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Keywords

Cisplatin; Ototoxicity; Hearing loss; Cancer

Cite this article

South African Medical Journal 2014;104(4):288-291. DOI:10.7196/SAMJ.7389

Article History

Date submitted: 2013-08-20
Date published: 2014-02-17

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