Ototoxicity beyond platinum-based derivatives

Abstract Purpose Ototoxicity caused by chemotherapy is a growing problem. Literature highlights the effects of platinum compounds. However, other chemotherapy drugs also have demonstrated audiological changes. The objective of this study was to compare pre- and post-treatment distortion product otoacoustic emissions (DPOAEs) in adult patients undergoing different chemotherapy regimens. Methods Cohort study comprising 174 individuals receiving chemotherapy (CT) between April 2022 and December 2023. DPOAE were evaluated in all patients at 2 kHz, 4 kHz, 6 kHz, 8 kHz, 10 kHz, and 12 kHz, before initiating chemotherapy and after completing the treatment. For differential analysis, the protocols were grouped into CT with platinum-based agents and other protocols. Results A reduction in response in at least one frequency of the DPOAE test was observed in 79% of the patients. 81% of those who received CT without platinum derivatives exhibited alterations in post-treatment examinations, whereas in the group with platinum-based compounds, alterations were observed in 79% of the subjects. Different percentages of response deterioration were observed across frequencies: 27.6% at 2 kHz, 24.6% at 4 kHz, 41.2% at 6 kHz, 58.8% at 8 kHz, 57.4% at 10 kHz, and 72.4% at 12 kHz. The ototoxic effect of chemotherapy protocols, with and without platinum, was more pronounced at higher frequencies, with no statistically significant difference between the groups. Conclusion Chemotherapy has shown signs of ototoxicity through changes in DPOAEs in the sample studied. The ototoxic effects were similar between drug protocols with and without platinum, highlighting the need for audiological monitoring in all chemotherapy patients.