1
|
Burger AVM, Duinkerken CW, van Sluis KE, de Boer JP, Navran A, Lanting CP, Jóźwiak K, Dreschler WA, Balm AJM, Zuur CL. Treatment-related hearing loss in weekly versus triweekly cisplatin chemoradiation for head and neck cancer. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08880-x. [PMID: 39242413 DOI: 10.1007/s00405-024-08880-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/29/2024] [Indexed: 09/09/2024]
Abstract
PURPOSE Cisplatin-induced hearing loss is a common side effect in patients treated with cisplatin-based chemoradiation (CRT) for head and neck squamous cell carcinoma. The extent of hearing loss after concurrent CRT was compared between triweekly (3 × 100 mg/m2) and weekly (7 × 40 mg/m2) cisplatin CRT. METHOD This retrospective cohort study was conducted in the Antoni van Leeuwenhoek Hospital and included 129 patients with cisplatin-based CRT for head and neck cancer (72 treated in the triweekly and 57 in the weekly regimen). Baseline and follow-up pure tone audiometry was conducted to assess hearing loss. Clinically relevant hearing loss was defined as a decline upon treatment of ≥ 10 decibel at a pure tone average 1-2-4 kHz and/or 8-10-12.5 kHz. RESULTS The incidence of clinically relevant cisplatin CRT induced hearing loss was 42% in the triweekly versus 19% in the weekly group (p < 0.01). The mean threshold shift at a pure tone average (PTA) 1-2-4 kHz was 9.0 decibel in the triweekly compared to 4.3 decibel in the weekly CRT group (p < 0.01). At PTA 8-10-12.5 kHz, the incidence of clinically relevant hearing loss was 75% in the triweekly compared to 74% in the weekly CRT group (p = 0.87). The mean threshold shift at PTA 8-10-12.5 kHz was 20.2 decibel versus 15.6 decibel, respectively (p = 0.07). CONCLUSION Cisplatin-dose reduction to a weekly cisplatin CRT regimen for head and neck cancer may reduce the incidence of clinically relevant hearing loss at frequencies vital for speech perception.
Collapse
Affiliation(s)
- A V M Burger
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
- Department of Otolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands
| | - C W Duinkerken
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
- Department of Otolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands
| | - K E van Sluis
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - J P de Boer
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A Navran
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C P Lanting
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - K Jóźwiak
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - W A Dreschler
- Department of Audiology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - A J M Balm
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
- Department of Maxillofacial Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - C L Zuur
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.
- Department of Otolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands.
| |
Collapse
|
2
|
Duinkerken CW, Chiodo S, Hueniken K, Hauptmann M, Jóźwiak K, Cheng D, Hope A, Liu G, Zuur CL. The role of genetic variants in the prediction of hearing loss due to cisplatin chemoradiotherapy. Cancer Med 2024; 13:e7465. [PMID: 39159054 PMCID: PMC11332395 DOI: 10.1002/cam4.7465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/26/2024] [Accepted: 05/28/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Concomitant high-dose cisplatin with radiotherapy is commonly used for treating head and neck squamous cell carcinoma (HNSCC). Cisplatin, often used with radiotherapy, is known for causing irreversible sensorineural hearing loss, with individual variability suggesting a genetic component. This study aims to enhance the predictive ability of the clinical prediction model for cisplatin-induced hearing loss (CIHL) in HNSCC patients, as outlined in Theunissen et al., by incorporating significant genetic variants. METHODS Conducted at the Netherlands Cancer Institute, this retrospective study included 74 patients treated between 1997 and 2011. Thirty-one SNPs that were previously associated with CIHL or other cisplatin-induced toxicities were identified and incorporated into the model. The primary outcome measured was the change in decibels at posttreatment 1-2-4 kHz hearing levels per additional minor allele of these SNPs, evaluated using linear mixed-effects regression models. The model's predictive accuracy was determined by the area under the curve (AUC) using 10-fold cross-validation. RESULTS The rs2289669 SNP in the SLC47A1/MATE1 gene was linked to a significant 2.67 dB increase in hearing loss per allele (95% CI 0.49-4.86, p = 0.017). Incorporating rs2289669 improved the model's AUC from 0.78 to 0.83, a borderline significant improvement (p = 0.073). CONCLUSIONS This study underscores the importance of the rs2289669 SNP in CIHL and demonstrates the potential of combining genetic and clinical data for enhanced predictive models in personalized treatment strategies.
Collapse
Affiliation(s)
- Charlotte W. Duinkerken
- Department of Otolaryngology and Head and Neck SurgeryLeiden University Medical CentreLeidenthe Netherlands
- Department of Head and Neck Surgerythe Netherlands Cancer InstituteAmsterdamthe Netherlands
| | - Sabrina Chiodo
- Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
- Department of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoCanada
| | - Katrina Hueniken
- Department of BiostatisticsUniversity Health NetworkTorontoCanada
| | - Michael Hauptmann
- Institute of Biostatistics and Registry ResearchBrandenburg Medical School Theodor FontaneNeuruppinGermany
| | - Katarzyna Jóźwiak
- Institute of Biostatistics and Registry ResearchBrandenburg Medical School Theodor FontaneNeuruppinGermany
| | - Dangxiao Cheng
- Department of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoCanada
| | - Andrew Hope
- Department of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoCanada
| | - Geoffrey Liu
- Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
- Department of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoCanada
| | - Charlotte L. Zuur
- Department of Otolaryngology and Head and Neck SurgeryLeiden University Medical CentreLeidenthe Netherlands
- Department of Head and Neck Surgerythe Netherlands Cancer InstituteAmsterdamthe Netherlands
| |
Collapse
|
3
|
Lee JJW, Alamleh S, Zhan LJ, Hueniken K, Mahler MB, Billfalk-Kelly A, Davies J, Brown MC, Spreafico A, Huang SH, Hope A, Xu W, Goldstein DP, Liu G. Clinical Predictors of Cisplatin Chemoradiation-Induced Ototoxicity in HPV-Positive Oropharyngeal Squamous Cell Carcinoma: A Case-Control Study. J Otolaryngol Head Neck Surg 2024; 53:19160216241248671. [PMID: 39056507 PMCID: PMC11282567 DOI: 10.1177/19160216241248671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Cisplatin-based chemoradiation is a standard treatment for many patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC), an etiologically distinct subset of head and neck cancer. Although associated with good long-term survival, clinical risk factors for ototoxicity have been understudied in this population. This study aimed to evaluate clinical predictors associated with ototoxicity in HPV-positive OPSCC patients treated with cisplatin chemoradiation. METHODS This retrospective case-control study included 201 adult patients (>18 years) with histologically confirmed HPV-positive OPSCC who received cisplatin chemoradiation as their primary treatment from 2001 and 2019 at a single tertiary cancer center. Ototoxicity was determined using baseline and follow-up audiometry and the Common Terminology Criteria for Adverse Events v5.0 grading criteria (Grade ≥2). Multivariable logistic regression [adjusted odds ratio (aOR)] identified significant predictors that increased the odds of ototoxicity. RESULTS A total of 201 patients [165 males; median (IQR) age, 57 (11) years] were included in the study. The incidence of ototoxicity in the worst ear was 56.2%, with the greatest hearing loss occurring at high frequencies (4-8 kHz), resulting in a loss of 12.5 dB at 4 to 6 kHz and 20 dB at 6 to 8 kHz. High-dose cisplatin administration compared to weekly administration [aOR 4.93 (95% CI: 1.84-14.99), P = .003], a higher mean cochlear radiation dose [aOR 1.58 (95% CI: 1.12-2.30), P = .01], smoking history [aOR 2.89 (95% CI: 1.51-5.63), P = .001], and a 10 year increase in age [aOR 2.07 (95% CI: 1.25-3.52), P = .006] were each independently associated with increased odds of ototoxicity. CONCLUSIONS Clinical predictors of ototoxicity in HPV-positive OPSCC patients treated with cisplatin-based chemoradiation include the use of a high-dose cisplatin regimen, higher cochlear radiation doses, a history of smoking, and older age. With the rising incidence of this malignancy in Western countries and overall improved survivorship, our research motivates future studies into risk stratification and earlier interventions to mitigate and reduce the risk of ototoxicity.
Collapse
Affiliation(s)
- John JW. Lee
- Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, ON, Canada
| | | | - Luna Jia Zhan
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Katrina Hueniken
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Mary B. Mahler
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Astrid Billfalk-Kelly
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Joel Davies
- Department of Otolaryngology—Head and Neck Surgery, Sinai Health System, University of Toronto, Toronto, ON, Canada
| | - M. Catherine Brown
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Anna Spreafico
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Shao Hui Huang
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Andrew Hope
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - David P. Goldstein
- Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, ON, Canada
- Department of Otolaryngology—Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Geoffrey Liu
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
4
|
Batool S, Sohail S, Ud Din F, Alamri AH, Alqahtani AS, Alshahrani MA, Alshehri MA, Choi HG. A detailed insight of the tumor targeting using nanocarrier drug delivery system. Drug Deliv 2023; 30:2183815. [PMID: 36866455 DOI: 10.1080/10717544.2023.2183815] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Human struggle against the deadly disease conditions is continued since ages. The contribution of science and technology in fighting against these diseases cannot be ignored exclusively due to the invention of novel procedure and products, extending their size ranges from micro to nano. Recently nanotechnology has been gaining more consideration for its ability to diagnose and treat different cancers. Different nanoparticles have been used to evade the issues related with conservative anticancer delivery systems, including their nonspecificity, adverse effects and burst release. These nanocarriers including, solid lipid nanoparticles (SLNs), liposomes, nano lipid carriers (NLCs), nano micelles, nanocomposites, polymeric and magnetic nanocarriers, have brought revolutions in antitumor drug delivery. Nanocarriers improved the therapeutic efficacy of anticancer drugs with better accumulation at the specific site with sustained release, improved bioavailability and apoptosis of the cancer cells while bypassing the normal cells. In this review, the cancer targeting techniques and surface modification on nanoparticles are discussed briefly with possible challenges and opportunities. It can be concluded that understanding the role of nanomedicine in tumor treatment is significant, and therefore, the modern progressions in this arena is essential to be considered for a prosperous today and an affluent future of tumor patients.
Collapse
Affiliation(s)
- Sibgha Batool
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.,Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Saba Sohail
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.,Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Fakhar Ud Din
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.,Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Ali H Alamri
- Department of Pharmaceutics, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Ahmad S Alqahtani
- Department of Pharmacy, Mental Health Hospital, Ministry of Health, Abha, Saudi Arabia
| | - Mohammad A Alshahrani
- Department of Medical Supply in Khamis Mushet General Hospital, Ministry of Health, Khamis Mushet, Saudi Arabia
| | - Mohammed A Alshehri
- Department of Pharmacy, Abha Maternity and Children Hospital, Ministry of Health, Abha, Saudi Arabia
| | - Han Gon Choi
- College of Pharmacy & Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, South Korea
| |
Collapse
|
5
|
Han AY, Nader ME, Lam K, Su SY. Current status of sinonasal cancer survivorship care. Head Neck 2023; 45:2458-2468. [PMID: 37449544 DOI: 10.1002/hed.27457] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 06/16/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
Sinonasal cancer is a heterogeneous orphan disease of diverse histologies, each with distinct clinical, oncologic, and toxicity profiles. Because of the comparative rarity of these cancers, sinonasal cancers are treated as a grouped diagnosis despite their clinical and biological heterogeneity. Multimodality treatment with a combination of surgery, chemotherapy, and/or radiotherapy is the standard-of-care for advanced-stage patients but there are few surveillance or follow-up practice guidelines or formalized survivorship care pathways. A scoping literature review was conducted via PubMed, EMBASE, and Google Scholar. A total of 112 studies were included, which were grouped along the following topics: surveillance, second primary tumors, quality of life, and symptom burden. Sinonasal cancer tends to exhibit a higher rate of local failure and occur in a delayed fashion compared to mucosal malignancies of the head and neck. Moreover, the site of failure and time-varying risk of recurrence is histology-specific. Following multimodality treatment of the skull base, patients may experience endocrine, visual, auditory, sinonasal, olfactory, and neurocognitive deficits, as well as psychosocial impairments that impact multiple physical and neuropsychological domains, resulting in diminished quality of life. Sinonasal cancer patients would benefit from tailored, histology-specific survivorship programs to address the recurrence, second primary, and functional impairments resulting from disease and treatment toxicity.
Collapse
Affiliation(s)
- Albert Y Han
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Marc-Elie Nader
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Keng Lam
- Department of Neuro-Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Shirley Y Su
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
6
|
Zitelli L, Palmer C, Mamula E, Johnson J, Rauterkus G, Nilsen ML. Hearing screening and amplifier uptake results in a multidisciplinary head and neck cancer survivorship clinic. J Cancer Surviv 2023; 17:720-728. [PMID: 35348995 PMCID: PMC11186601 DOI: 10.1007/s11764-022-01198-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/28/2021] [Indexed: 10/18/2022]
Abstract
PURPOSE Hearing loss and tinnitus are prevalent among survivors of head and neck cancer (HNC), but auditory issues are under-addressed in the survivorship literature. The purpose of this study was to describe the hearing loss and management experience of a group of survivors provided with a hearing screening and amplifier assistance if needed during their visit. METHODS A retrospective chart review of 1176 individuals seen in the HNC Survivorship Clinic between December 2016 and October 2020 who interacted with audiology was performed. RESULTS Of these survivors, 72% failed the 30-dB HL hearing screening at one or more frequencies. Thirty-three percent of the sample reported tinnitus. Consistent with the general population, this group has a low prevalence of hearing aid use. In this clinic, individuals who fail the hearing screening at all frequencies are offered a simple, non-custom amplifier for use during their visit. Thirty-one percent of individuals offered the amplifier used it during their Survivorship Clinic visit to enhance communication and reduce listening effort. Only 54% of individuals who failed the hearing screening self-reported hearing loss. The poor sensitivity and specificity associated with the self-perception of hearing loss data support the need for hearing screening that consists of responding to tones. Of individuals who received a recommendation for a comprehensive hearing test, 21% received a hearing test with 68% of these individuals receiving the hearing test the same day of their Survivorship Clinic visit. CONCLUSIONS The data from 1176 survivors of HNC seen by audiology over the past few years as part of the UPMC HNC Survivorship Clinic support the need for hearing management in this population to improve communication during and after the Survivorship Clinic visit. IMPLICATIONS FOR CANCER SURVIVORS Survivors of HNC have a high prevalence of greater than mild hearing loss and tinnitus (both issues known to negatively impact health-related communication and quality of life). This manuscript describes a hearing screening program within a Survivorship Clinic that identifies individuals in need of non-custom amplification during their appointment to support effective communication. Survivors should be referred to audiologists for evaluation and management of treatment-related issues of hearing.
Collapse
Affiliation(s)
- Lori Zitelli
- UPMC, 203 Lothrop St., 4th Floor, Pittsburgh, PA, 15213, USA.
- University of Pittsburgh, Pittsburgh, PA, USA.
| | - Catherine Palmer
- UPMC, 203 Lothrop St., 4th Floor, Pittsburgh, PA, 15213, USA
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Jonas Johnson
- UPMC, 203 Lothrop St., 4th Floor, Pittsburgh, PA, 15213, USA
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Marci L Nilsen
- UPMC, 203 Lothrop St., 4th Floor, Pittsburgh, PA, 15213, USA
- University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
7
|
Kim SS, Liu HC, Mell LK. Treatment Considerations for Patients with Locoregionally Advanced Head and Neck Cancer with a Contraindication to Cisplatin. Curr Treat Options Oncol 2023; 24:147-161. [PMID: 36696081 PMCID: PMC9992074 DOI: 10.1007/s11864-023-01051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/26/2023]
Abstract
OPINION STATEMENT Significant advancements have been made in the treatment of locally advanced head and neck cancer, predominantly driven by the integration of concurrent chemotherapy with radiation therapy as a standard of care for many patients. The most heavily investigated chemotherapeutic is cisplatin, yet many patients are ineligible for cisplatin due to the presence of pre-existing medical comorbidities. Moreover, given the toxicity profile of cisplatin, identifying which patients stand to benefit from cisplatin is challenging, which is particularly evident in older patients. Efforts to better risk-stratify patients based on age, performance status, and the degree of pre-existing comorbidities are ongoing and have been increasingly utilized in national clinical trials. In parallel, exploration into alternative systemic agents, including novel targeted therapies and immunotherapies, in cisplatin-ineligible patients are rapidly expanding. Cumulatively, identifying appropriate treatment paradigms in patients who harbor contraindications to cisplatin can not only improve clinical outcomes but also critically mitigate detrimental adverse effects.
Collapse
Affiliation(s)
- Sangwoo S Kim
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, 3855 Health Sciences Drive, MC0843, La Jolla, CA, 92093, USA
| | - Hannah C Liu
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, 3855 Health Sciences Drive, MC0843, La Jolla, CA, 92093, USA
| | - Loren K Mell
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, 3855 Health Sciences Drive, MC0843, La Jolla, CA, 92093, USA.
| |
Collapse
|
8
|
Lee DS, Mahal RS, Tharakan T, Cathryn Collopy, Kallogjeri D, Thorstad WL, Adkins DR, Oppelt P, Ley J, Wick CC, Zevallos J. Hearing Outcomes in a Deintensification Trial of Adjuvant Therapy for HPV-Related Oropharyngeal Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2023; 168:1089-1096. [PMID: 36939390 DOI: 10.1002/ohn.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/27/2022] [Accepted: 10/08/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To explore whether deintensification of adjuvant therapy reduces ototoxicity among patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). STUDY DESIGN Retrospective cohort study. SETTING Single academic center. METHODS The ototoxicity rate among adult patients with HPV-related OPSCC enrolled in the Minimalist Trial (MINT), a prospective phase 2 trial of surgery followed by risk-adjusted deintensified adjuvant therapy (42 Gy radiation given alone or with a single 100 mg/m2 dose of cisplatin), was compared to that among a historical cohort treated with standard adjuvant therapy (60-66 Gy radiation with up to three 100 mg/m2 doses of cisplatin). Ototoxicity was defined as Common Terminology Criteria for Adverse Events v5.0 ≥ Grade 2. Mixed model analysis was performed to investigate the association between deintensified adjuvant therapy and treatment-related hearing loss. RESULTS A total of 29 patients (58 ears) were analyzed in the MINT cohort, and 27 patients (54 ears) in the historical cohort. The ototoxicity rate was 5% (n = 3/58 ears) in the MINT cohort and 46% (n = 25/54 ears) in the historical cohort (difference, 41%; 95% confidence interval [CI] = 27%-56%). Patients in the MINT cohort demonstrated a 95% decrease in risk of ototoxicity compared to those in the historical cohort (adjusted odds ratio: 0.05, 95% CI = 0.01-0.31). Differences in estimated marginal mean threshold shifts were statistically and clinically significant at frequencies ≥ 3 kHz. CONCLUSION The deintensified adjuvant therapy given in MINT led to less ototoxicity than standard adjuvant therapy among patients with HPV-related OPSCC.
Collapse
Affiliation(s)
- David S Lee
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Rajwant S Mahal
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Theresa Tharakan
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Cathryn Collopy
- Department of Otolaryngology-Head and Neck Surgery, Division of Adult Audiology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Dorina Kallogjeri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Wade L Thorstad
- Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Douglas R Adkins
- Department of Medical Oncology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Peter Oppelt
- Department of Medical Oncology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Jessica Ley
- Department of Medical Oncology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Cameron C Wick
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Jose Zevallos
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| |
Collapse
|
9
|
Okada H, Kitagawa K. Risk factors associated with cisplatin-induced ototoxicity in Japanese patients with solid tumors. Cancer Med 2022; 12:7904-7910. [PMID: 36567514 PMCID: PMC10134260 DOI: 10.1002/cam4.5565] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Cisplatin, a first-generation platinum agent, is used for managing various cancers and is associated with dose-dependent side effects of hearing impairment and tinnitus. However, the safety of high-dose cisplatin in hearing impairment, has not been fully investigated in Japan. METHODS We performed pure-tone threshold audiometry before and every 3-4 weeks after chemotherapy for patients receiving cisplatin-containing chemotherapy between April 2015 and October 2017 at Kobe Minimally Invasive Cancer Center. Hearing impairment was evaluated prospectively using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. RESULTS We enrolled 100 patients and analyzed 96 patients for whom post-chemotherapy audiometry could be performed. The median patient age was 65 years, and most patients were male (75). The cancer types were as follows: esophageal, 36; head and neck, 35; lung, 23; and gastric, 2. Cisplatin monotherapy and combination therapy were administered to 33 and 63 patients, respectively. A single cisplatin dose was 60-100 mg/m2 ; the median number of doses and total dose were 3 and 240 mg/m2 , respectively. Additionally, 78 and 18 patients were treated with concurrent chemoradiotherapy and chemotherapy alone, respectively. Twenty-seven patients had grade 2 or higher hearing impairment. Furthermore, the prevalence was significantly higher in patients receiving a total dose of ≥300 mg/m2 . Twenty and 32 patients were aware of deafness and tinnitus, respectively. CONCLUSION No patient discontinued treatment owing to hearing impairment. The total cisplatin dose was considered related to post-treatment hearing impairment frequency in Japanese patients. However, routine audiometric monitoring is recommended during high-dose cisplatin-based chemotherapy.
Collapse
Affiliation(s)
- Hideaki Okada
- Division of Medical Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
| | - Koichi Kitagawa
- Division of Medical Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
| |
Collapse
|
10
|
Yücel B, Erdiş E, Bahar S, Akkaş Atasever E, Celasun MG, Altuntaş EE. Factors Affecting Permanent Sensorineural Hearing Loss and Bone Conduction in Patients After Receiving Radiotherapy to the Head and Neck Region. Turk Arch Otorhinolaryngol 2022; 60:212-219. [PMID: 37456600 PMCID: PMC10339269 DOI: 10.4274/tao.2022.2022-6-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/27/2022] [Indexed: 07/18/2023] Open
Abstract
Objective This study aimed to investigate the factors affecting permanent sensorineural hearing loss (SNHL) and causing changes in bone conduction (BC) thresholds over time in patients after receiving radiotherapy (RT) or chemoradiotherapy (CRT) to the head and neck region. Methods A total of 63 patients with irradiated HNC that were admitted to the Radiation Oncology Department between 2011 and 2018 were included in the study. All patients were assessed with pure tone audiometry at eight different time points (first before RT and last five years after completion of RT). A chi-square test was used to analyze the variables that affected permanent SNHL occurrence. Repeated measure analysis of variance was conducted to investigate the factors affecting change in the BC threshold at pure-tone average (0.5-2 kHz) and the air conduction (AC) threshold at 4 and 6 kHz frequencies over time. Results Median follow-up was 52 months (range, 12-110 months). SNHL was found in 18 (14%) of the 126 ears. According to the receiver operating characteristic analysis, the cut-off values of cochlear Dmean and Dmax radiation doses were 40 Gy [p=0.017, area under the curve (AUC): 0.676] and 45 Gy (p=0.008, AUC: 0.695). Dmean (≤40 Gy vs. >40 Gy) and Dmax (≤45 Gy vs. >45 Gy) cochlear doses and age (≤40 vs. >40 years) were determined as factors affecting SNHL in the chi-square test. Repeated measures showed that BC thresholds between 0.5-2 kHz and AC thresholds at 4 and 6 kHz increased over time. Age (≤40 vs. >40 years), treatment of head and neck cancer (RT vs. CRT), cisplatin use, and Dmean (≤40 Gy vs. >40 Gy) and Dmax cochlear dose (≤45 Gy vs. >45 Gy) were important factors affecting the course of BC threshold over time. Conclusion Dmean and Dmax cochlear doses and age were found to be associated with permanent SNHL. Conduction thresholds worsened over time at all frequencies, and this trend was affected by cochlear doses, age, CRT, and cisplatin use.
Collapse
Affiliation(s)
- Birsen Yücel
- Department of Radiation Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Eda Erdiş
- Department of Radiation Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Seher Bahar
- Department of Radiation Oncology, University of Health Sciences Turkey, Balıkesir Atatürk City Hospital, Balıkesir, Turkey
| | - Ebru Akkaş Atasever
- Department of Radiation Oncology, University of Health Sciences Turkey, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Mustafa Gürol Celasun
- Department of Radiation Oncology, University of Health Sciences Turkey, Kütahya Evliya Çelebi Training and Research Hospital, Kütahya, Turkey
| | - Emine Elif Altuntaş
- Department of Otorhinolaryngology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| |
Collapse
|
11
|
Lee DS, Schrader A, Warchol M, Sheets L. Cisplatin exposure acutely disrupts mitochondrial bioenergetics in the zebrafish lateral-line organ. Hear Res 2022; 426:108513. [PMID: 35534350 PMCID: PMC9745743 DOI: 10.1016/j.heares.2022.108513] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/18/2022] [Accepted: 05/02/2022] [Indexed: 12/16/2022]
Abstract
Cisplatin is a commonly used chemotherapeutic agent that causes debilitating high-frequency hearing loss. No targeted therapies currently exist to treat cisplatin ototoxicity, partly because the underlying mechanisms of cisplatin-induced hair cell damage are not completely defined. Zebrafish may offer key insights to cisplatin ototoxicity because their lateral-line organ contains hair cells that are remarkably similar to those within the cochlea but are optically accessible, permitting observation of cisplatin injury in live intact hair cells. In this study, we used a combination of genetically encoded biosensors in zebrafish larvae and fluorescent indicators to characterize changes in mitochondrial bioenergetics in response to cisplatin. Following exposure to cisplatin, confocal imaging of live intact neuromasts demonstrated increased mitochondrial activity. Staining with fixable fluorescent dyes that accumulate in active mitochondria similarly showed hyperpolarized mitochondrial membrane potential. Zebrafish expressing a calcium indicator within their hair cells revealed elevated levels of mitochondrial calcium immediately following completion of cisplatin treatment. A fluorescent ROS indicator demonstrated that these changes in mitochondrial function were associated with increased oxidative stress. After a period of recovery, cisplatin-exposed zebrafish demonstrated caspase-3-mediated apoptosis. Altogether, these findings suggest that cisplatin acutely disrupts mitochondrial bioenergetics and may play a key role in initiating cisplatin ototoxicity.
Collapse
Affiliation(s)
- David S. Lee
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, 660 S. Euclid Ave. Campus Box 8115, St. Louis, MO 63110, USA,Corresponding author at: Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, 660 S. Euclid Ave. Campus Box 8115, St. Louis, MO 63110, USA. (D.S. Lee)
| | - Angela Schrader
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, 660 S. Euclid Ave. Campus Box 8115, St. Louis, MO 63110, USA
| | - Mark Warchol
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, 660 S. Euclid Ave. Campus Box 8115, St. Louis, MO 63110, USA,Department of Neuroscience, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Lavinia Sheets
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, 660 S. Euclid Ave. Campus Box 8115, St. Louis, MO 63110, USA,Department of Developmental Biology, Washington University School of Medicine, St. Louis, MO 63110, USA
| |
Collapse
|
12
|
Ohkoshi A, Ikeda R, Suzuki J, Yamamoto T, Ishii R, Higashi K, Wakamori S, Nakayama Y, Nakanome A, Ogawa T, Katori Y. Eustachian Tube Functions in Concurrent Chemoradiotherapy for Head and Neck Cancer Patients. Indian J Otolaryngol Head Neck Surg 2022; 74:6307-6312. [PMID: 36742578 PMCID: PMC9895678 DOI: 10.1007/s12070-021-03058-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/27/2021] [Indexed: 02/07/2023] Open
Abstract
Ototoxicity is a dose-limiting adverse event for concurrent chemoradiotherapy (CCRT) with high-dose cisplatin for locally advanced head and neck squamous cell carcinoma (HNSCC). Both irradiation to the Eustachian tube (ET) and weight loss are risk factors for patulous ET. The aim of this prospective, observational study was to elucidate the incidences of patulous ET conditions before and after CCRT in HNSCC patients by means of ET function tests. This prospective, observational study was conducted in 27 HNSCC patients who received CCRT with high-dose cisplatin, and ET function tests (sonotubometry and tubo-tympano-aerodynamic graphy) were performed before and 3 months after CCRT. Factors potentially affecting the incidence of patulous ET conditions after CCRT were evaluated. Of the 54 ears from 27 patients investigated, patulous ET conditions were observed in 12 ears (22.2%) from 9 patients (33.3%) before CCRT and 15 ears (27.8%) from 11 patients (40.7%) at 3 months after CCRT. Only patulous ET conditions before CCRT in each ear were significantly associated with patulous ET conditions after CCRT (p = 0.010). This is the first report to describe the incidences of patulous ET conditions before and after CCRT in HNSCC patients. HNSCC patients are potentially at higher risk of patulous ET.
Collapse
Affiliation(s)
- Akira Ohkoshi
- Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575 Japan
| | - Ryoukichi Ikeda
- Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575 Japan
| | - Jun Suzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575 Japan
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575 Japan
| | - Ryo Ishii
- Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575 Japan
| | - Kenjiro Higashi
- Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575 Japan
| | - Shun Wakamori
- Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575 Japan
| | - Yuki Nakayama
- Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575 Japan
| | - Ayako Nakanome
- Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575 Japan
| | - Takenori Ogawa
- Department of Otolaryngology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1193 Japan
| | - Yukio Katori
- Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575 Japan
| |
Collapse
|
13
|
Patatt FSA, Gonçalves LF, Paiva KMD, Haas P. Ototoxic effects of antineoplastic drugs: a systematic review. Braz J Otorhinolaryngol 2022; 88:130-140. [PMID: 33757754 PMCID: PMC9422719 DOI: 10.1016/j.bjorl.2021.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/11/2021] [Accepted: 02/06/2021] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Platinum-based chemotherapeutics play an important role in the treatment of cancer at different levels and are the most cited ototoxic agents when scientific evidence is analyzed. OBJECTIVE To present scientific evidence based on a systematic literature review, PRISMA, in order to systematize information on the ototoxic effects of using antineoplastic drugs. METHODS For the selection of studies, the combination based on the Medical Subject Heading Terms (MeSH) was used. The Medline (Pubmed), LILACS, SciELO, SCOPUS, WEB OF SCIENCE and BIREME databases were used, without restriction of language, period, and location. Evaluation of the quality of the articles was carried out, which included articles with a minimum score of 6 in the modified scale of the literature. The designs of the selected studies were descriptive, cohort, and cross-sectional, which were related to the research objective. RESULTS Three articles were included in this systematic review. The ototoxicity caused by cisplatin alone varied from 45% to 83.3%, while that caused by the use associated with carboplatin varied from 16.6% to 75%. There was a significant variation in the cumulative doses of these antineoplastic agents, both in isolated and in combination. Auditory changes, especially at high frequencies, were evident after completion of treatment. CONCLUSION Auditory changes after the use of platinum-based antineoplastic drugs were found, however, there was an important heterogeneity regarding the frequency of ototoxicity and the cumulative dose of the drugs used.
Collapse
Affiliation(s)
| | | | | | - Patrícia Haas
- Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| |
Collapse
|
14
|
Deutsch BC, Collopy C, Kallogjeri D, Piccirillo JF. Validation of Hearing Loss Prediction Tool for Cisplatin Chemotherapy and Radiation in Head and Neck Cancer Treatment. JAMA Otolaryngol Head Neck Surg 2021; 147:182-189. [PMID: 33300954 DOI: 10.1001/jamaoto.2020.4620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Importance Hearing loss affects up to 88% of patients undergoing head and neck cancer treatment; however, there are few validated models to predict this outcome. A predictive posttreatment model for hearing loss will allow clinicians and patients to make well-informed decisions about treatment with cisplatin-based chemotherapies and radiotherapy. Objective To validate a previously created predictive model for objective hearing outcomes and to assess barriers to using the prediction nomogram in general practice for patients newly diagnosed with head and neck cancer. Design, Setting, and Participants This cohort study includes an evaluation of 105 patients (208 ears) and interviews with 6 clinicians. The patients were treated at a high-volume tertiary care hospital. Patient participants were newly diagnosed with head and neck cancer and treated at Siteman Cancer Center from July 1, 2018, to December 31, 2019, with radiotherapy both with and without cisplatin-based chemotherapy. Additionally, the clinicians involved in the care of patients with head and neck cancer were interviewed to assess implementation strategies. Exposures Radiotherapy with and without cisplatin-based chemotherapy. Main Outcomes and Measures Hearing defined by the audiometric pure-tone average of 1, 2, and 4 kHz. Results A total of 105 patients (208 ears; mean [SD] age, 61 [11] years; 82 men [78%]) were compared with the development cohort to assess the similarities and differences in case mix. All patients underwent radiation therapy, 50 (48%) received cisplatin-based chemotherapy, and 67 (64%) had a surgical resection. The mean (SD) cochlear dose of radiation was 13 (12) Gy, and the mean (SD) total cisplatin dose was 238 (83) mg/m2 for those undergoing cisplatin therapy. A calibration curve demonstrated that predicted and observed posttreatment pure-tone average were not significantly different. The model predicted a posttreatment pure-tone average greater than 35 dB (a common threshold for hearing aid consideration) with a sensitivity of 73% and specificity of 67% with an area under the curve of 0.71, showing good discrimination. Clinician interviews suggest the nomogram requires careful integration into patient counseling to clarify risks and benefits for treatment. Conclusions and Relevance The findings of this cohort study confirm this model's ability to predict posttreatment hearing outcomes in a unique population of patients. This model has the potential to inform pretreatment counseling and posttreatment hearing evaluations for this patient population.
Collapse
Affiliation(s)
- Brian C Deutsch
- Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Cathryn Collopy
- Division of Adult Audiology, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Dorina Kallogjeri
- Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Jay F Piccirillo
- Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| |
Collapse
|
15
|
Qi Y, Yang W, Liu S, Han F, Wang H, Zhao Y, Zhou Y, Zhou D. Cisplatin loaded multiwalled carbon nanotubes reverse drug resistance in NSCLC by inhibiting EMT. Cancer Cell Int 2021; 21:74. [PMID: 33494783 PMCID: PMC7836500 DOI: 10.1186/s12935-021-01771-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 01/11/2021] [Indexed: 12/25/2022] Open
Abstract
Background Lung cancer is one of the important health threats worldwide, of which 5-year survival rate is less than 15%. Non-small-cell lung cancer (NSCLC) accounts for about 80% of all lung cancer with high metastasis and mortality. Methods Cisplatin loaded multiwalled carbon nanotubes (Pt-MWNTS) were synthesized and used to evaluate the anticancer effect in our study. The NSCLC cell lines A549 (cisplatin sensitive) and A549/DDP (cisplatin resistant) were used in our in vitro assays. MTT was used to determine Cancer cells viability and invasion were measured by MTT assay and Transwell assay, respectively. Apoptosis and epithelial-mesenchymal transition related marker proteins were measured by western blot. The in vivo anti-cancer effect of Pt-MWNTs were performed in male BALB/c nude mice (4-week old). Results Pt-MWNTS were synthesized and characterized by X-ray diffraction, Raman, FT-IR spectroscopy and scan electron microscopy. No significant cytotoxicity of MWNTS was detected in both A549/DDP and A549 cell lines. However, Pt-MWNTS showed a stronger inhibition effect on cell growth than free cisplatin, especially on A549/DDP. We found Pt-MWNTS showed higher intracellular accumulation of cisplatin in A549/DDP cells than free cisplatin and resulted in enhanced the percent of apoptotic cells. Western blot showed that application of Pt-MWNTS can significantly upregulate the expression level of Bax, Bim, Bid, Caspase-3 and Caspase-9 while downregulate the expression level of Bcl-2, compared with free cisplatin. Moreover, the expression level of mesenchymal markers like Vimentin and N-cadherin was more efficiently reduced by Pt-MWNTS treatment in A549/DDP cells than free cisplatin. In vivo study in nude mice proved that Pt-MWNTS more effectively inhibited tumorigenesis compared with cisplatin, although both of them had no significant effect on body weight. Conclusion Pt-MWNT reverses the drug resistance in the A549/DDP cell line, underlying its possibility of treating NSCLC with cisplatin resistance.
Collapse
Affiliation(s)
- Yuxin Qi
- Department of Respiratory Medicine, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, 271199, China
| | - Wenping Yang
- Department of Respiratory Medicine, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, 271199, China
| | - Shuang Liu
- Department of Respiratory Medicine, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, 271199, China
| | - Fanjie Han
- Department of Respiratory Medicine, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, 271199, China
| | - Haibin Wang
- Department of Respiratory Medicine, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, 271199, China
| | - Yonghong Zhao
- Department of Respiratory Medicine, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, 271199, China
| | - Yufa Zhou
- Department of Respiratory Medicine, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, 271199, China
| | - Daijun Zhou
- Department of Oncology, General Hospital of Western Theater Command of PLA, Chengdu, 610083, China.
| |
Collapse
|
16
|
Kita A, Saldate J, Chang C, Chellappa N, Jong J, Matsuda R, Schmidt A, Shih B, Shafqat I, Schoettler K, Acharya S, Seidlits S, Hoffman L. Implantable Drug Reservoir Devices for Inner Ear Delivery of Pharmacotherapeutics. Otolaryngol Head Neck Surg 2020; 163:791-798. [DOI: 10.1177/0194599820930229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective Cisplatin is a platinum-based chemotherapeutic drug that secondarily induces toxicity in inner ear sensory epithelia, contributing to auditory and vestibular dysfunction. We describe the creation of a drug reservoir device (DRD) to combat this ototoxicity for the duration of chemotherapy. As ototoxic side effects of chemotherapy may limit an oncologist’s ability to prescribe first-line agents such as cisplatin, mitigating such devastating effects through prolonged topical therapy would be tremendously valuable. Study Design We investigated (1) the ability of an electrospun polylactic acid DRD to provide prolonged delivery of the posited otoprotectant metformin and (2) the development of an in vitro model utilizing Sh-Sy5y human neuroblastoma cells to assess the efficacy of metformin in reducing cisplatin-induced toxicity. Setting Neurophysiology laboratory. Methods Basic science experiments were performed to assess DRD properties and metformin’s effects on cisplatin toxicity in culture. Results We found that DRDs with increasing polylactic acid concentrations exhibited metformin release for up to 8 weeks. In modeling elution across the round window in vitro, continued elution of metformin was observed for at least 6 weeks, as quantified by spectrophotometry. Unfortunately, metformin did not exhibit protective efficacy in this model using Sh-Sy5y cells. Conclusion While metformin was not found to be protective in Sh-Sy5y cells, these results suggest that an electrospun DRD can provide a tailorable drug delivery system providing medication for the duration of chemotherapy treatment. This represents a novel drug delivery system and efficacy screening assay with broad clinical applications in personalized delivery of inner ear therapies.
Collapse
Affiliation(s)
- Ashley Kita
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Johnny Saldate
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Courtney Chang
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Nitika Chellappa
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Jeremy Jong
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Riley Matsuda
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Andrew Schmidt
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Brandon Shih
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Iram Shafqat
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Kari Schoettler
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Shiv Acharya
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Stephanie Seidlits
- Brain Research Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Larry Hoffman
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Brain Research Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| |
Collapse
|
17
|
Theodoroff SM, Konrad-Martin D. Noise: Acoustic Trauma and Tinnitus, the US Military Experience. Otolaryngol Clin North Am 2020; 53:543-553. [PMID: 32334867 DOI: 10.1016/j.otc.2020.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Tinnitus is commonly experienced by military Service Members and Veterans, especially by the newest generation who served in Iraq and Afghanistan. When patients seek health care for tinnitus, it is important to determine its type, check for comorbid conditions that might be triggering or exacerbating the condition, and to address its functional and psychosocial effects. Otolaryngologists are usually the first health care professional to evaluate a patient with tinnitus, and it is essential to provide appropriate referrals for this high-burden condition. Noise-induced tinnitus is multifaceted; by performing a thorough assessment, appropriate action can be taken to best meet the needs of patients.
Collapse
Affiliation(s)
- Sarah M Theodoroff
- VA RR&D National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, Portland, OR, USA; Department of Otolaryngology/Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA.
| | - Dawn Konrad-Martin
- VA RR&D National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, Portland, OR, USA; Department of Otolaryngology/Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| |
Collapse
|
18
|
Fernandez K, Spielbauer KK, Rusheen A, Wang L, Baker TG, Eyles S, Cunningham LL. Lovastatin protects against cisplatin-induced hearing loss in mice. Hear Res 2020; 389:107905. [PMID: 32062294 DOI: 10.1016/j.heares.2020.107905] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/13/2020] [Accepted: 01/30/2020] [Indexed: 12/14/2022]
Abstract
Cisplatin is used to treat a variety of solid tumors in both children and adults. However, cisplatin has serious side-effects, some of which may permanently affect patients' quality of life following treatment, such as ototoxicity. There is currently no FDA-approved therapy for the prevention or treatment of cisplatin-induced hearing loss. Herein we examine the potential for statins to prevent cisplatin-induced ototoxicity. Statins, a class of drugs commonly used to prevent or manage hypercholesterolemia, have been of clinical utility for decades with dependable outcomes and reliable safety profiles in humans. Statins are known to be protective in animal models of noise-induced and age-related hearing loss. Moreover, studies have demonstrated an additive benefit of statins in cancer treatment. In the current study, lovastatin reduces cisplatin-induced hearing loss in adult mice. Lovastatin-mediated protection was significantly greater among female than male mice, and the dose of lovastatin required for protection was different between the sexes. Taken together our data indicate that lovastatin reduces cisplatin-induced hearing loss in mice and suggest that concurrent statin and cisplatin therapy may represent a feasible clinical strategy for reducing cisplatin-induced ototoxicity that should be explored for future clinical use.
Collapse
Affiliation(s)
- Katharine Fernandez
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Katie K Spielbauer
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Aaron Rusheen
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Lizhen Wang
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Tiffany G Baker
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Stephen Eyles
- Department of Biochemistry and Molecular Biology and Mass Spectrometry, Core, University of Massachusetts, Amherst, MA, USA
| | - Lisa L Cunningham
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA.
| |
Collapse
|
19
|
Matuschek C, Haussmann J, Bölke E, Gripp S, Schuler PJ, Tamaskovics B, Gerber PA, Djiepmo-Njanang FJ, Kammers K, Plettenberg C, Anooshahr B, Orth K, Budach W. Accelerated vs. conventionally fractionated adjuvant radiotherapy in high-risk head and neck cancer: a meta-analysis. Radiat Oncol 2018; 13:195. [PMID: 30286777 PMCID: PMC6172789 DOI: 10.1186/s13014-018-1133-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 09/14/2018] [Indexed: 12/16/2022] Open
Abstract
Background Adjuvant radiotherapy in advanced head and neck squamous cell cancer (HNSCC) reduces the risk of local-regional failure and most likely increases the survival rate. Patients at high risk for tumor recurrence may benefit from more aggressive altered fractionation schedules in order to reduce the overall time from surgery to completion of radiotherapy. Here, we reviewed the results of six randomized trials addressing the above hypothesis. Methods In the six trials of interest, a total of 988 patients with locally advanced HNSCC were randomly assigned to receive either accelerated or conventionally fractionated adjuvant radiotherapy. Hazard ratios (HR) were extracted from available publications for local-regional control, distant metastasis as well as overall-, cancer specific- and disease-free survival. Meta-analysis of the effect sizes was performed using fixed and random effect models. Acute and late side effects were categorized and summarized for comparison. Results Accelerated radiotherapy did not improve the loco-regional control (n = 988, HR = 0.740, CI = 0.48–1.13, p = 0.162), progression-free survival (HR = 0.89, CI = 0.76–1.04, p = 0.132) or overall survival (HR = 0.88, CI = 0.75–1.04, p = 0.148) significantly. Acute confluent mucositis occurred with significant higher frequency with accelerated radiotherapy. Late side effects did not differ significantly in either group. Conclusion Accelerated radiotherapy does not result in a significant improvement of loco-regional control or overall survival in high-risk patients. Acute but not late radiation toxicity were more frequent with the accelerated RT technique. In clinical practice accelerated postoperative radiation therapy might be a suitable option only for a subset of patients.
Collapse
Affiliation(s)
- Christiane Matuschek
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Jan Haussmann
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Edwin Bölke
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany.
| | - Stephan Gripp
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Patrick J Schuler
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Bálint Tamaskovics
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Peter Arne Gerber
- Department of Dermatology, Medical Faculty Heinrich Heine University Dusseldorf, Dusseldorf, Germany
| | - Freddy-Joel Djiepmo-Njanang
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Kai Kammers
- Division of Biostatistics and Bioinformatics, Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christian Plettenberg
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Heinrich Heine University Dusseldorf, Dusseldorf, Germany
| | | | - Klaus Orth
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Wilfried Budach
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| |
Collapse
|
20
|
King KA, Brewer CC. Clinical trials, ototoxicity grading scales and the audiologist's role in therapeutic decision making. Int J Audiol 2017; 57:S89-S98. [PMID: 29276851 DOI: 10.1080/14992027.2017.1417644] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Define clinical trials and adverse event (AE) monitoring from the perspective of the audiologist. Rationalise the importance of audiology's involvement before, during and after monitoring. Identify strengths and weaknesses in toxicity grading scales, and discuss factors that may influence these. DESIGN Literature involving commonly cited grading scales used to capture ototoxicity is reviewed. Current regulations and language associated with clinical trial implementation and AE monitoring are described. Personal observations based on a variety of clinical populations are drawn from years of experience developing and employing ototoxicity monitoring protocols in a complex medical setting. RESULTS Six commonly used grading scales for ototoxicity are systematically reviewed for strengths and weaknesses. Necessary considerations that inform selection of grading scales are presented. A review of and historical context for clinical trial development and AE monitoring is provided. CONCLUSIONS The audiologist's role in therapeutic decision making goes beyond collection of the audiogram. Clear communication to stakeholders in ototoxicity monitoring is paramount, and toxicity grading scales are one tool to facilitate this exchange. Various factors should be considered in advance of selecting the most appropriate scale to capture hearing loss, and no scale is without limitation.
Collapse
Affiliation(s)
- Kelly A King
- a Audiology Unit, Otolaryngology Branch , National Institute on Deafness and Other Communication Disorders, National Institutes of Health , Bethesda , MD , USA
| | - Carmen C Brewer
- a Audiology Unit, Otolaryngology Branch , National Institute on Deafness and Other Communication Disorders, National Institutes of Health , Bethesda , MD , USA
| |
Collapse
|