Impact of cisplatin-related hearing loss (HL) and tinnitus on patient functioning.

Abstract

e23085 Background: Patients given cisplatin-based chemotherapy (CBC) experience HL and tinnitus. However, the impact of these toxicities on psychosocial and physical functioning in cancer survivors has not been systematically evaluated. Methods: Eligible testicular cancer survivors (TCS) aged ≤ 55 y at diagnosis and given first-line CBC at Indiana U., completed comprehensive questionnaires. The validated 25-item Hearing Handicap Inventory for Adults (HHIA) quantified emotional (13 items) and social difficulties (12 items) related to HL. The validated 20-item Tinnitus Primary Function Questionnaire (TPFQ) assessed domains affected by tinnitus, i.e., concentration, emotion, hearing, sleep (5 items each). For each HHIA scale, TCS were grouped into 3 standard handicap levels: 0–16% (none/minimal), 18-42% (mild/moderate), and 44-100% (significant). Proportions of social vs. emotional handicap were compared with a McNemar’s test. For TPFQ, each scale score is continuous (0: [no interference] to 100% [total interference by tinnitus]) and computed as the mean of 5 items. TPFQ measures were compared by signed-rank tests (P < 0.05 was significant). Results: Of 43 TCS (median age: 35 y, range 20–74 y; median time since chemotherapy completion: 7 y, range 2-27 y), 95% were white, and 70% had at least a college degree. Median cumulative cisplatin dose was 300 (range 200-600 mg/m2). The most commonly administered regimen was bleomycin, etoposide and cisplatin; 23 (53.5%) reported HL, and 25 (58%) had tinnitus. Of TCS with HL, 25% had some degree of related handicap (total HHIA scale: 20% and 5% for mild/moderate and significant handicap, respectively). More TCS had social vs. emotional handicap (33.3% vs. 14.3%, P = 0.13). Tinnitus had significantly greater interference with emotion (median: 14, range 0-84) compared to concentration [(median 6, range 0-41), p = 0.04)], and sleep [(median: 0, range (0-78), p = 0.001)]. Other comparisons were not significant. Conclusions: Cisplatin-related HL has a considerably greater negative impact on social vs. emotional measures, and affected TCS may benefit from hearing aids. TCS experiencing significant issues related to emotion due to tinnitus may benefit from interventions to lessen their impact.