Ototoxicity among adult cancer patients receiving parenteral chemotherapy in Lagos, Nigeria

Abstract Background Cancer is one of the most commonly diagnosed non-communicable diseases and one of the leading causes of death worldwide. Advances in the management of cancer, which include chemotherapy, have led to an increase in the 5-year relative survival rate. Cancer survivors, however, are faced with therapy-associated adverse effects such as ototoxicity, manifesting as hearing loss and tinnitus. Ototoxicity has a substantial impact on the patient’s quality of life. The prevalence of chemotherapy-associated ototoxicity varies with the type of chemotherapy drugs, age, and genetic predisposition of the population studied. This study aims to assess the prevalence of ototoxicity among adult Nigerian cancer patients treated solely with chemotherapy and to identify the chemotherapeutic drug class associated with ototoxicity. Methods A prospective, multi-center, hospital-based cohort study of 169 adult cancer patients who received chemotherapy alone was conducted using consecutive recruitment. Clinical and hearing assessments with pure tone audiograms were carried out on all patients twice, pre-treatment and 4–6 weeks post-treatment. Changes in hearing sensitivity compared to the pre-treatment measurement determined ototoxicity. Results Adults aged 18 years and above were recruited, but the actual study patients’ age range was from 22 to 75 years, with a mean of 52.3 ± 11.5 SD. The most common cancers were breast cancer (116 cases, 68.6%) and hepatic cancer (15 cases, 8.9%). Platinum-based and non–platinum–based chemotherapeutic regimens were administered to 40 (23.7%) and 129 (76.3%) participants, respectively. While a 52.75% prevalence of audiometrically confirmed hearing loss was noted, the self-reported prevalence of ototoxicity was 48.5%. The prevalence of hearing loss among those treated with platinum-based and non-platinum-based drugs was 90% (36/40) and 41.1% (53/129), respectively. Also, severe sensorineural hearing loss was noted in 45% of patients. Conclusion Ototoxicity was highly prevalent in adult cancer patients treated solely with chemotherapy. However, this study reports a high prevalence of ototoxicity among patients treated with non-platinum-based drugs compared to what is existing in the literature.