Impact of Hearing Loss and Tinnitus in Cancer Survivors

项目摘要 神经毒性化疗所致听力损失和耳鸣的研究 主要集中在儿科病人。对于成年人来说，极其有限的工作量 报告了与使用铂化合物有关的听力损失和耳鸣 主要用于正在接受睾丸或头颈部癌症积极治疗的患者。 然而，还没有研究系统地评估癌症中的听力损失和耳鸣。 接受铂和/或紫杉烷化合物治疗胸部、胃肠道(GI)的幸存者， 妇科(妇科)，或肺癌。鉴于这些诊断是四种最常见的 成人癌症以及铂和紫杉烷化合物是治疗这些疾病的主要药物。 癌症，评估这些药物对听力损失和耳鸣的严重程度和影响 对于癌症的生存来说是一个重要的问题。最近，我们完成了正在进行的 R01(CA151692)，侧重于表型和分子差异的评估 400例CIN和200例CIN存活者化疗后神经病的特点 没有CIN的幸存者。在310名CIN患者的初步分析数据中，49.0%的人报告 听力损失和/或耳鸣(即16.1%的人报告只有听力损失，12.3%的人报告只有耳鸣， 20.6%的人同时报告听力损失和耳鸣)。相比之下，在79名没有CIN的患者中， 72.2%的患者未报告听力损失或耳鸣。鉴于几乎50%的CIN患者 报告了某种形式的听觉毒性，这项拨款申请将集中在更详细的 听力损失和耳鸣的特征，以确定其潜在的机制和 对存活者功能水平和生活质量的影响。血液样本将被采集和储存，用于 未来的基因组分析。这项研究的主要目的是，在接受了 铂和/或紫杉烷化合物，分为四个基团之一(即，1) 无CIN、听力损失和耳鸣的幸存者；2)有CIN且无听力损失的幸存者 和耳鸣；3)CIN和仅听力损失的幸存者；以及4)CIN和两者的幸存者 听力损失和耳鸣)，是为了：1)评估四组之间主观上的差异 2)评价四组间的差异 耳鸣的主观特征；3)评估四组在耳鸣方面的差异 功能状态、认知状态、经济毒性和生活质量。这项研究的次要目的是 评估存活者CIN主观和客观指标随时间的变化 符合CA151692标准的CIN患者。关于病因和严重性的信息，以及 关于这两种类型的听觉毒性的影响，将被用于计划干预研究 改善听力，减少耳鸣的影响，并帮助癌症幸存者适应长期 听力损失和耳鸣的足月影响。

Project Summary Research on hearing loss and tinnitus associated with neurotoxic chemotherapy (CTX) has focused primarily on pediatric patients. In adults, the extremely limited amount of work has reported on hearing loss and tinnitus associated with the administration of platinum compounds primarily in patients undergoing active treatment for testicular or head and neck cancer. However, no studies have systematically evaluated hearing loss and tinnitus in cancer survivors who received a platinum and/or a taxane compound for breast, gastrointestinal (GI), gynecological (GYN), or lung cancer. Given that these diagnoses are the four most common cancers in adults and platinum and taxane compounds are the mainstay of treatment for these cancers, an evaluation of the severity and impact of hearing loss and tinnitus from these drugs is a significant issue for cancer survivorship. Recently, we completed enrollment in our ongoing R01 (CA151692) that is focused on an evaluation of differences in phenotypic and molecular characteristics of chemotherapy-induced neuropathy (CIN) in 400 survivors with CIN and 200 survivors without CIN. In preliminary analyses data from 310 patients with CIN, 49.0% reported hearing loss and/or tinnitus (i.e., 16.1% reported only hearing loss, 12.3% reported only tinnitus, and 20.6% reported both hearing loss and tinnitus). In contrast, in the 79 patients without CIN, 72.2% did NOT report hearing loss or tinnitus. Given that almost 50% of the patients with CIN reported some form of auditory toxicity, this grant application will focus on a more detailed characterization of hearing loss and tinnitus to determine their underlying mechanisms and impact of survivors' level of function and QOL. Blood samples will be collected and stored for future genomic analyses. The primary aims of this study, in a sample of survivors who received a platinum and/or a taxane compound and are classified into one of four groups (i.e., 1) survivors without CIN, hearing loss, and tinnitus; 2) survivors with CIN and without hearing loss and tinnitus; 3) survivors with CIN and only hearing loss; and 4) survivors with CIN and both hearing loss and tinnitus), are to: 1) evaluate for differences among the four groups in subjective and objective characteristics of hearing loss; 2) evaluate for differences among the four groups in subjective characteristics of tinnitus; and 3) evaluate for differences among the four groups in functional status, cognitive status, financial toxicity, and QOL. The secondary aim of this study is to evaluate for changes over time in subjective and objective measures of CIN in the survivors with CIN who were evaluated in CA151692. The information on etiology and severity, as well as on the impact of these two types of auditory toxicity will be used to plan intervention studies to improve hearing, reduce the impact of tinnitus, and assist cancer survivors to adapt to the long term effects of hearing loss and tinnitus.