Insight into the current practice of ototoxicity monitoring during cisplatin therapy
Abstract Background The aim of this study is to evaluate the current state of ototoxicity monitoring for patients receiving cisplatin chemotherapy in an academic medical center with particular attention to how closely monitoring adheres to national ototoxicity guidelines. Methods Case series includi...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-03-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | https://doi.org/10.1186/s40463-021-00506-0 |
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| author | N. M. Santucci B. Garber R. Ivory M. A. Kuhn M. Stephen D. Aizenberg |
| author_facet | N. M. Santucci B. Garber R. Ivory M. A. Kuhn M. Stephen D. Aizenberg |
| author_sort | N. M. Santucci |
| collection | DOAJ |
| description | Abstract Background The aim of this study is to evaluate the current state of ototoxicity monitoring for patients receiving cisplatin chemotherapy in an academic medical center with particular attention to how closely monitoring adheres to national ototoxicity guidelines. Methods Case series including retrospective medical records review of patients (age > 18) treated with cisplatin at University of California Davis Medical Center between January 2014 and August 2017. Patient and ototoxicity related variables were analyzed. Patients that underwent a transfer of care during treatment and with less than 3 months of follow-up were excluded. Results Three hundred seventy-nine patients met study criteria, of which 104 (27.4%) had a prior history of hearing loss. Prior to treatment, 196 (51.7%) patients were counseled regarding the ototoxic nature of cisplatin and 92 (24.3%) patients had a pretreatment audiogram. During treatment, 91 (24%) patients had documented otologic complaints. Only 17 patients (4.5%) patients had an audiogram ordered during their cisplatin treatment period. 130 (34.3%) patients had otologic complaints following cisplatin treatment. Audiograms were ordered for 20 (7.8%), 13 (5.1%), and 16 (6.2%) patients at 1-month, 3-month, and 6-month follow-ups, respectively. No patients in the study cohort received baseline, treatment, and post-treatment audiograms as recommended by national ototoxicity monitoring protocols. Patients with Head and Neck Cancer (HNC) represented the largest subgroup that received cisplatin (n = 122, 32.2%) and demonstrated higher rates of ototoxicity counseling (n = 103, 84.4%) and pretreatment audiograms (n = 70, 57.4%) compared to the non HNC group (n = 36, 36.2%, P < 0.0001 and n = 22, 8.5%, P < 0.0001). Conclusions There is poor adherence to national ototoxicity monitoring guidelines at a large academic medical center. This is a missed opportunity for intervention and aural rehabilitation. Improved education and collaboration between otolaryngology, audiology, and medical oncology is needed to develop and promote an effective ototoxicity-monitoring program. Graphical abstract |
| format | Article |
| id | doaj-art-00760dd2ed374c1581ed4b36abeffc27 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-00760dd2ed374c1581ed4b36abeffc272025-02-03T10:51:14ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162021-03-015011710.1186/s40463-021-00506-0Insight into the current practice of ototoxicity monitoring during cisplatin therapyN. M. Santucci0B. Garber1R. Ivory2M. A. Kuhn3M. Stephen4D. Aizenberg5Oregon Health and Science University, School of MedicineUniversity of California Davis Department of Otolaryngology-Head and Neck SurgeryUniversity of California Davis Medical CenterUniversity of California Davis Department of Otolaryngology-Head and Neck SurgeryUniversity of California Davis Department of Internal Medicine – Hematology/OncologyUniversity of California Davis Department of Otolaryngology-Head and Neck SurgeryAbstract Background The aim of this study is to evaluate the current state of ototoxicity monitoring for patients receiving cisplatin chemotherapy in an academic medical center with particular attention to how closely monitoring adheres to national ototoxicity guidelines. Methods Case series including retrospective medical records review of patients (age > 18) treated with cisplatin at University of California Davis Medical Center between January 2014 and August 2017. Patient and ototoxicity related variables were analyzed. Patients that underwent a transfer of care during treatment and with less than 3 months of follow-up were excluded. Results Three hundred seventy-nine patients met study criteria, of which 104 (27.4%) had a prior history of hearing loss. Prior to treatment, 196 (51.7%) patients were counseled regarding the ototoxic nature of cisplatin and 92 (24.3%) patients had a pretreatment audiogram. During treatment, 91 (24%) patients had documented otologic complaints. Only 17 patients (4.5%) patients had an audiogram ordered during their cisplatin treatment period. 130 (34.3%) patients had otologic complaints following cisplatin treatment. Audiograms were ordered for 20 (7.8%), 13 (5.1%), and 16 (6.2%) patients at 1-month, 3-month, and 6-month follow-ups, respectively. No patients in the study cohort received baseline, treatment, and post-treatment audiograms as recommended by national ototoxicity monitoring protocols. Patients with Head and Neck Cancer (HNC) represented the largest subgroup that received cisplatin (n = 122, 32.2%) and demonstrated higher rates of ototoxicity counseling (n = 103, 84.4%) and pretreatment audiograms (n = 70, 57.4%) compared to the non HNC group (n = 36, 36.2%, P < 0.0001 and n = 22, 8.5%, P < 0.0001). Conclusions There is poor adherence to national ototoxicity monitoring guidelines at a large academic medical center. This is a missed opportunity for intervention and aural rehabilitation. Improved education and collaboration between otolaryngology, audiology, and medical oncology is needed to develop and promote an effective ototoxicity-monitoring program. Graphical abstracthttps://doi.org/10.1186/s40463-021-00506-0OtotoxicityCisplatinHearing lossAudiogramAudiologicOtologic |
| spellingShingle | N. M. Santucci B. Garber R. Ivory M. A. Kuhn M. Stephen D. Aizenberg Insight into the current practice of ototoxicity monitoring during cisplatin therapy Journal of Otolaryngology - Head and Neck Surgery Ototoxicity Cisplatin Hearing loss Audiogram Audiologic Otologic |
| title | Insight into the current practice of ototoxicity monitoring during cisplatin therapy |
| title_full | Insight into the current practice of ototoxicity monitoring during cisplatin therapy |
| title_fullStr | Insight into the current practice of ototoxicity monitoring during cisplatin therapy |
| title_full_unstemmed | Insight into the current practice of ototoxicity monitoring during cisplatin therapy |
| title_short | Insight into the current practice of ototoxicity monitoring during cisplatin therapy |
| title_sort | insight into the current practice of ototoxicity monitoring during cisplatin therapy |
| topic | Ototoxicity Cisplatin Hearing loss Audiogram Audiologic Otologic |
| url | https://doi.org/10.1186/s40463-021-00506-0 |
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