Impact of Hearing Loss and Tinnitus in Cancer Survivors

项目摘要 神经毒性化疗（CTX）相关的听力损失和耳鸣研究 主要针对儿科患者。在成年人中，极其有限的工作量 报告了与铂化合物给药相关的听力损失和耳鸣 主要用于正在积极治疗睾丸癌或头颈癌的患者。 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乳腺、胃肠道（GI） 妇科（GYN）或肺癌。鉴于这些诊断是四种最常见的 而铂和紫杉烷化合物是治疗这些癌症的主要药物 癌症，评估这些药物对听力损失和耳鸣的严重程度和影响 是癌症存活率的重要问题。最近，我们完成了正在进行的 R01（CA151692），其重点是评估表型和分子水平的差异， 在400名CIN幸存者和200名CIN幸存者中， 没有CIN的幸存者在310例CIN患者的初步分析数据中，49.0%报告 听力损失和/或耳鸣（即，16.1%仅报告听力损失，12.3%仅报告耳鸣， 20.6%的人同时报告听力损失和耳鸣）。相比之下，在79名无CIN的患者中， 72.2%没有报告听力损失或耳鸣。鉴于近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一个更详细的 表征听力损失和耳鸣，以确定其潜在机制， 影响幸存者的功能水平和生活质量。将采集血液样本并储存， 未来的基因分析这项研究的主要目的，在一个样本的幸存者谁收到 铂和/或紫杉烷化合物并被分为四组之一（即，第一章 无CIN、听力损失和耳鸣的幸存者; 2）有CIN但无听力损失的幸存者 和耳鸣; 3）CIN幸存者和听力损失;和4）CIN幸存者和两者 听力损失和耳鸣），是：1）评估四组之间的主观差异， 听力损失的客观特征; 2）评估四组之间的差异 耳鸣的主观特征; 3）评估四组之间的差异， 功能状态、认知状态、经济毒性和QOL。本研究的第二个目的是 评价生存者CIN的主观和客观指标随时间的变化 在CA151692中评价的CIN患者。关于病因和严重程度的信息，以及 这两种类型的听觉毒性的影响将用于计划干预研究， 改善听力，减少耳鸣的影响，并协助癌症幸存者适应长期的生活。 听力损失和耳鸣的危害

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.