Prevention and treatment of cisplatin-induced ototoxicity in adults: A systematic review
Date
2023-09-23
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Abstract
Objectives: Ototoxicity is a common disabling side effect of platinum-based chemotherapy. This study aimed to assess the evidence on the management of platinum-induced ototoxicity in adult cancer patients.
Methods: Four databases were searched up to 1 November 2022. Original studies were included if they reported on a pharmacologic or non-pharmacologic intervention to prevent or treat platinum ototoxicity in adults. The articles' quality was assessed via two grading scales.
Results: Nineteen randomised controlled trials and five quasi-experimental studies with 1673 patients were analysed. Eleven interventions were identified, nine pharmacological and two non-pharmacological. Six of the interventions (sodium thiosulphate, corticoids, sertraline, statins, multivitamins and D-methionine) showed mild benefits in preventing cisplatin-induced ototoxicity. Only one trial assessed corticoids as a potential treatment. Overall, only six trials were deemed with a low risk of bias. The majority of studies inadequately documented intervention-related adverse effects, thereby limiting safety conclusions.
Conclusions: Current interventions have mild benefits in preventing cisplatin-induced ototoxicity in adult cancer patients. Sodium thiosulphate is the most promising intervention as a preventive strategy. Rigorous, high-quality research is warranted, encompassing an evaluation of all potential symptoms and innovative treatment modalities.
Keywords: chemotherapy-related adverse events; cisplatin-induced ototoxicity; hearing loss; otoprotection; platinum chemotherapy.
Description
The primary aim was to systematically review the effectiveness and safety of pharmacological or non-pharmacological interventions used to prevent or treat platinum-induced ototoxicity in adult cancer patients. Even though ototoxicity is a less common adverse effect of other chemotherapy agents, we consider that studies could report ototoxicity interventions for multiple chemotherapy regimens. So, our secondary aim was to assess pharmacological or non-pharmacological interventions for ototoxicity caused by other chemotherapy agents in adult cancer patients.
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Correa-Morales JE, Giraldo-Moreno S, Mantilla-Manosalva N, Cuellar-Valencia L, Borja-Montes OF, Bedoya-Muñoz LJ, Iriarte-Aristizábal MF, Quintero-Muñoz E, Zuluaga-Liberato AM. Prevention and treatment of cisplatin-induced ototoxicity in adults: A systematic review. Clin Otolaryngol. 2024 Jan;49(1):1-15. doi: 10.1111/coa.14106. Epub 2023 Oct 11. PMID: 37818931.