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Cancer survivors and neurotoxic chemotherapy: hearing loss and tinnitus
  1. Steven Cheung1,
  2. Jennifer Henderson-Sabes1,
  3. Judith Mastick2,
  4. Gary Abrams1,
  5. Karin Snowberg2,
  6. Emely Alfaro3,
  7. Marisa Quinn3,
  8. Steven Paul2,
  9. Bruce Cooper2,
  10. Margaret Wallhagen2,
  11. Yvette Conley4,
  12. Jon Levine1 and
  13. Christine Miaskowski2
  1. 1 School of Medicine, UCSF, San Francisco, California, USA
  2. 2 School of Nursing, UCSF, San Francisco, California, USA
  3. 3 Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, CA, USA
  4. 4 School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
  1. Correspondence to Dr Christine Miaskowski, School of Nursing, UCSF, San Francisco, CA 94143, USA; chris.miaskowski{at}


Objectives Little is known about hearing loss and tinnitus associated with neurotoxic chemotherapy. Study evaluated for differences in occurrence rates and effects of hearing loss and tinnitus in survivors who received a platinum alone, a taxane alone or a platinum and taxane containing regimen.

Methods Total of 273 survivors with breast, gastrointestinal, gynaecological or lung cancer completed self-report measures of hearing loss and tinnitus and had an audiometric assessment that obtained pure tone air conduction thresholds bilaterally at frequencies of between 0.25 kHz to 16.0 kHz. To adjust for age-related and gender-related changes in hearing, each survivor’s audiogram was evaluated using the National Health and Nutrition Examination Survey-modified Occupational Safety and Health Administration standards. Survivor was classified as having hearing loss if at any frequency they scored poorer than the 50th percentile for their age and gender. Survivors were categorised as having tinnitus if they reported that for >10% of their time awake, they were consciously aware of their tinnitus. Differences among the chemotherapy groups were evaluated using parametric and non-parametric tests.

Results For most of the demographic and clinical characteristics, no differences were found among the three chemotherapy groups. Occurrence rates for audiogram-confirmed hearing loss ranged from 52.3% to 71.4%. Occurrence rates for tinnitus ranged from 37.1% to 40.0%. No differences were found among the three chemotherapy groups in the occurrence rates or effects of hearing loss and tinnitus.

Conclusion These findings suggest that regardless of the chemotherapy regimen common mechanistic pathway(s) may underlie these two neurotoxicities.

  • Cancer
  • Clinical assessment
  • Supportive care
  • Survivorship
  • Symptoms and symptom management

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Contributors All authors substantially contributed to the conception and design of the study, data analysis, data interpretation and the drafting of the manuscript. All authors approved the final version of the manuscript. CM is responsible for the overall content of the manuscript

  • Funding This study was funded by the National Cancer Institute (NCI, CA151692) and the American Cancer Society (ACS). CM is an American Cancer Society Clinical Research Professor. This project was supported by the National Centre for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI, grant number UL1 TR000004.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.