Ototoxicity After Cisplatin-Based Chemotherapy: Factors Associated With Discrepancies Between Patient-Reported Outcomes and Audiometric Assessments.
Ototoxicity After Cisplatin-Based Chemotherapy: Factors Associated With Discrepancies Between Patient-Reported Outcomes and Audiometric Assessments.
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DOI：
10.1097/aud.0000000000001172
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Travis, Lois B.
中科院分区：
文献类型：
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作者：
Ardeshirrouhanifard, Shirin;Fossa, Sophie D.;Huddart, Robert;Monahan, Patrick O.;Fung, Chunkit;Song, Yiqing;Dolan, M. Eileen;Feldman, Darren R.;Hamilton, Robert J.;Vaughn, David;Martin, Neil E.;Kollmannsberger, Christian;Dinh, Paul;Einhorn, Lawrence;Frisina, Robert D.;Travis, Lois B.
旨在提供有关成人癌症幸存者在顺铂化疗 (CBCT) 后报告的听力损失和听力测定定义的听力损失 (HL) 之间差异的相关因素的新信息，并全面调查与听力测定定义的 HL 相关的危险因素。 CBCT 后 6 个月以上的 1,410 名睾丸癌幸存者 (TCS) 接受了全面的听力评估（0.25-12 kHz）并完成了问卷调查。 HL 严重程度是使用美国言语听力协会 (ASHA) 标准定义的。多变量多项回归确定了与患者报告和听力测定定义的 HL 之间差异相关的因素，多变量序数回归评估了与后者相关的因素。总体而言，34.8% 的 TCS 自我报告 HL。在无耳鸣的 TCS 中，仅在扩展高频 (EHF)（10-12 kHz）（17.8%）或同时在 EHF 和标准频率（0.25-8 kHz）（23.4%）时具有听力测定定义的 HL 的患者（23.4%）比没有听力测定定义的 HL 的患者（8.1%）更有可能自我报告 HL（OR=2.48；95%CI， 1.31-4.68 和 OR= 3.49；95%CL，1.89-6.44）。年龄较大（OR=1.09；95%CI，1.07-1.11，P<0.0001），之前没有接触过噪音（OR=1.40；95%CI，1.06-1.84，P=0.02），混合/传导性HL（OR=2.01；95%CI，1.34-3.02，P=0.0007），无助听器使用（OR=5.64；95%CI，1.84-17.32，P=0.003）和较低教育程度（OR，2.12；95%CI，1.23-3.67，P=0.007，高中或以下教育程度与研究生教育水平）与听力测定定义的 HL 严重程度的低估程度相关，而耳鸣则与更高的高估程度相关（对于轻微耳鸣，OR，4.65；95%CI，2.64-8.20；对于相当多耳鸣，OR，5.87；95%CI，2.65-13.04；对于非常耳鸣，OR，10.57；95%CI，4.91-22.79，P<0.0001）。年龄较大（OR=1.13；95%CI，1.12-1.15，P<0.0001）、累积顺铂剂量（>300 mg/m2，OR=1.47；95%CI，1.21-1.80，P=0.0001）和高血压（OR=1.80；95%CI，1.28-2.52， P=0.0007）与 ASHA 定义的 HL 严重程度较高相关，而研究生教育（OR=0.58；95%CI，0.40-0.85，P=0.005）与较轻的 HL 相关。患者报告的 HL 与 CBCT 后听力测定定义的 HL 之间的差异是由多种因素造成的。对于自我报告 HL 但在标准频率下听力测试结果正常的幸存者，应考虑转介给听力学家进行额外测试并将 EHF 纳入听力测试评估中。
To provide new information on factors associated with discrepancies between patient-reported and audiometrically-defined hearing loss (HL) in adult-onset cancer survivors after cisplatin-based chemotherapy (CBCT) and to comprehensively investigate risk factors associated with audiometrically-defined HL. A total of 1,410 testicular cancer survivors (TCS) ≥6 months post-CBCT underwent comprehensive audiometric assessments (0.25-12 kHz) and completed questionnaires. HL severity was defined using American Speech-Language-Hearing Association (ASHA) criteria. Multivariable multinomial regression identified factors associated with discrepancies between patient-reported and audiometrically-defined HL, and multivariable ordinal regression evaluated factors associated with the latter. Overall, 34.8% of TCS self-reported HL. Among TCS without tinnitus, those with audiometrically-defined HL at only extended high frequencies (EHFs) (10-12 kHz) (17.8%) or at both EHFs and standard frequencies (0.25-8 kHz) (23.4%) were significantly more likely to self-report HL than those with no audiometrically-defined HL (8.1%) (OR=2.48; 95%CI, 1.31-4.68 and OR= 3.49; 95%CL,1.89-6.44, respectively). Older age (OR=1.09; 95%CI, 1.07-1.11, P<0.0001), absence of prior noise exposure (OR=1.40; 95%CI, 1.06-1.84, P=0.02), mixed/conductive HL (OR=2.01;95%CI, 1.34-3.02, P=0.0007), no hearing aid use (OR=5.64; 95%CI, 1.84-17.32, P=0.003), and lower education (OR, 2.12; 95%CI, 1.23-3.67, P=0.007 for high school or less education vs. post-graduate education) were associated with greater underestimation of audiometrically-defined HL severity, while tinnitus was associated with greater overestimation (OR, 4.65; 95%CI, 2.64-8.20 for a little tinnitus, OR, 5.87; 95%CI, 2.65-13.04 for quite a bit tinnitus, and OR, 10.57; 95%CI, 4.91-22.79 for very much tinnitus P<0.0001). Older age (OR=1.13; 95%CI, 1.12-1.15, P<0.0001), cumulative cisplatin dose (>300 mg/m2, OR=1.47; 95%CI, 1.21-1.80, P=0.0001), and hypertension (OR=1.80; 95%CI, 1.28-2.52, P=0.0007) were associated with greater ASHA-defined HL severity, whereas post-graduate education (OR=0.58; 95%CI, 0.40-0.85, P=0.005) was associated with less severe HL. Discrepancies between patient-reported and audiometrically-defined HL after CBCT are due to several factors. For survivors who self-report HL, but have normal audiometric findings at standard frequencies, referral to an audiologist for additional testing and inclusion of EHFs in audiometric assessments, should be considered.