Ototoxicity Monitoring: The Evolution of a Protocol for Head and Neck Cancer Patients.

Abstract

Objective: We evaluated an ototoxicity monitoring program (OMP) for improving audiologic follow-up in head and neck cancer (HNC) patients.

Study design: Retrospective cohort study.

Setting: Tertiary academic center.

Methods: Two hundred and forty patients were recommended for chemotherapy between January 2017 and June 2022. An OMP was implemented in March 2021; every patient received an audiology referral and was contacted to schedule a pretreatment audiogram. Patients were divided into pre-OMP and post-OMP cohorts. Main outcome measures included rates of pretreatment audiograms, posttreatment audiograms, posttreatment otologic symptoms, and hearing aid utilization.

Results: There were 131 patients evaluated pre-OMP and 109 evaluated post-OMP. The mean age for all patients was 62.8 ± 11.9 years; 76.3% were male. After the implementation of the OMP, a significantly higher proportion of patients received a pretreatment audiogram (66.1% vs 34.4%, P < .001), with enrolled patients being 3.8 times more likely to obtain 1 (95% confidence interval: 2.2-6.6), P < .001). There was a significant increase in reported otologic symptoms after implementing the program (18% vs 36%, P = .002). However, the rate of hearing aid utilization decreased after OMP implementation (pre-OMP: 33% vs post-OMP: 13%, P = .02).

Conclusion: Implementation of an OMP significantly improved the proportion of HNC patients that underwent pretreatment audiograms prior to systemic therapy; however, audiologic follow-up remained largely unchanged in the posttreatment period.

Level of evidence: Level 4.