Platinum Chemotherapy Triggers Hearing Loss in 72 Percent of Cancer Patients, Suggests Study
A recent prospective cohort study published in the Indian Journal of Otolaryngology and Head & Neck Surgery revealed that 72.2% of cancer patients (65 of 90) developed irreversible, bilateral sensorineural hearing loss after receiving platinum chemotherapy. These striking results highlight the critical need for routine baseline and ongoing hearing monitoring in clinical oncology.
While cisplatin is an effective chemotherapeutic agent, its clinical utility is limited by severe side effects like permanent sensorineural hearing loss. To address this clinical gap, Harneet Kaur and colleagues prospectively evaluated ototoxicity patterns in head and neck cancer patients undergoing cisplatin therapy.
Therefore, the prospective cohort study evaluated 90 patients with head and neck malignancies undergoing cisplatin chemotherapy, using baseline audiometry to exclude pre-existing presbycusis. The primary endpoint was determining the overall incidence and severity of post-treatment sensorineural hearing loss.
Key clinical findings of the study include:
- High Ototoxic Prevalence: The cohort demonstrated that 72.2% of enrolled oncology patients (65 out of 90 individuals) developed measurable post-chemotherapy SNHL.
- Cytotoxic Mechanisms of Cochlear Damage: The analysis established that cisplatin triggers inner ear toxicity primarily through ROS generation, lipid peroxidation, and activation of apoptotic pathways.
- Rigorous Baseline Audiometric Screening: The trial confirmed that pre-treatment audiometric evaluation successfully excluded baseline presbycusis, ensuring documented hearing deficits were directly attributable to platinum exposure.
- Broad Spectrum of Systemic Toxicities: The research revealed that ototoxicity frequently co-occurs alongside other dose-limiting adverse events, including nephrotoxicity, peripheral neuropathy, myelosuppression, ocular toxicity, gonadotoxicity, and severe emesis.
- High Clinical Need for Early Detection: The investigation underscored that routine audiometric evaluations are essential for identifying early, subclinical auditory declines before severe irreversible hearing impairment occurs.
The results suggest that cisplatin chemotherapeutic regimens induce a substantial burden of auditory dysfunction, with 72.2% (65 of 90) of head and neck cancer patients developing SNHL post-treatment. These findings establish that inner ear damage represents a frequent, dose-limiting clinical complication that requires heightened clinical awareness during platinum-based cancer therapy.
Thus, the study concludes that clinicians administering cisplatin-based chemotherapeutic protocols should consider incorporating routine baseline and serial post-treatment audiometric surveillance into standard patient care to facilitate early detection and proactive clinical management of hearing impairment.
While the prospective cohort study provided valuable clinical evidence regarding ototoxicity in 90 patients with head and neck malignancies, expanded multicenter investigations across larger and more diverse patient populations will further clarify dose-dependent thresholds, individual susceptibility factors, and potential otoprotective interventions.
Reference
Kaur H, Singh J, Chauhan A, Kalra V, Singh S, Sharma S, Manglik S. Cisplatin Induced Ototoxicity in Patients with Head and Neck Malignancies: A Clinical Study. Indian Journal of Otolaryngology and Head & Neck Surgery. Published online September 11, 2026.
