Antioxidants in the Prevention of Cisplatin-Induced Hearing Loss: A Systematic Review and Meta-Analysis

Background Cisplatin is a commonly used chemotherapeutic drug that is associated with irreversible hearing loss. A number of antioxidants have been investigated for prevention, but data have so far been inconclusive. Objective The objective of this study was to assess the efficacy of vari...

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Main Authors: Rich Ericson C. King, Kimberly Mae C. Ong
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2022-06-01
Series:Asian Journal of Oncology
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1748637
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author Rich Ericson C. King
Kimberly Mae C. Ong
author_facet Rich Ericson C. King
Kimberly Mae C. Ong
author_sort Rich Ericson C. King
collection DOAJ
description Background Cisplatin is a commonly used chemotherapeutic drug that is associated with irreversible hearing loss. A number of antioxidants have been investigated for prevention, but data have so far been inconclusive. Objective The objective of this study was to assess the efficacy of various antioxidant therapies in preventing hearing loss among adult patients treated with cisplatin. Methodology We searched for controlled clinical trials evaluating various antioxidants as prevention against cisplatin-induced hearing loss in adults. The primary outcome is the proportion of patients with hearing loss. Secondary outcomes include audiometric threshold shifts, tinnitus, tumor response, adverse events, and quality of life. Results Thirteen randomized trials comprising of nine antioxidant therapies were included. Only coenzyme Q with multivitamins demonstrated significant benefit in preventing cisplatin-induced hearing loss (relative risk: 0.15, 95% confidence interval: 0.04–0.58) in a small study, while data for the rest of the agents were inconclusive. Audiometric threshold shifts were significantly lower in the intervention arm for aspirin, vitamin E, and transtympanic dexamethasone. The available data on tumor response was inconclusive, with no definite evidence of diminished tumor response noted. Adverse events noted include mild ear pain particularly for transtympanic therapies. There was no data available on quality of life. Conclusion The current available evidence is so far insufficient to establish any benefit for antioxidant therapies for the prevention of cisplatin-induced hearing loss. More high-quality studies are needed to fill in the identified gaps in knowledge.
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spelling doaj.art-98f22e4d9dfe45f8afa56253018e73cb2022-12-22T00:21:48ZengThieme Medical Publishers, Inc.Asian Journal of Oncology2454-67982455-46182022-06-0110.1055/s-0042-1748637Antioxidants in the Prevention of Cisplatin-Induced Hearing Loss: A Systematic Review and Meta-AnalysisRich Ericson C. King0Kimberly Mae C. Ong1Department of Clinical Epidemiology, University of the Philippines College of Medicine, Manila, PhilippinesDepartment of Clinical Epidemiology, University of the Philippines College of Medicine, Manila, PhilippinesBackground Cisplatin is a commonly used chemotherapeutic drug that is associated with irreversible hearing loss. A number of antioxidants have been investigated for prevention, but data have so far been inconclusive. Objective The objective of this study was to assess the efficacy of various antioxidant therapies in preventing hearing loss among adult patients treated with cisplatin. Methodology We searched for controlled clinical trials evaluating various antioxidants as prevention against cisplatin-induced hearing loss in adults. The primary outcome is the proportion of patients with hearing loss. Secondary outcomes include audiometric threshold shifts, tinnitus, tumor response, adverse events, and quality of life. Results Thirteen randomized trials comprising of nine antioxidant therapies were included. Only coenzyme Q with multivitamins demonstrated significant benefit in preventing cisplatin-induced hearing loss (relative risk: 0.15, 95% confidence interval: 0.04–0.58) in a small study, while data for the rest of the agents were inconclusive. Audiometric threshold shifts were significantly lower in the intervention arm for aspirin, vitamin E, and transtympanic dexamethasone. The available data on tumor response was inconclusive, with no definite evidence of diminished tumor response noted. Adverse events noted include mild ear pain particularly for transtympanic therapies. There was no data available on quality of life. Conclusion The current available evidence is so far insufficient to establish any benefit for antioxidant therapies for the prevention of cisplatin-induced hearing loss. More high-quality studies are needed to fill in the identified gaps in knowledge.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1748637hearing lossototoxicitysupportive care
spellingShingle Rich Ericson C. King
Kimberly Mae C. Ong
Antioxidants in the Prevention of Cisplatin-Induced Hearing Loss: A Systematic Review and Meta-Analysis
Asian Journal of Oncology
hearing loss
ototoxicity
supportive care
title Antioxidants in the Prevention of Cisplatin-Induced Hearing Loss: A Systematic Review and Meta-Analysis
title_full Antioxidants in the Prevention of Cisplatin-Induced Hearing Loss: A Systematic Review and Meta-Analysis
title_fullStr Antioxidants in the Prevention of Cisplatin-Induced Hearing Loss: A Systematic Review and Meta-Analysis
title_full_unstemmed Antioxidants in the Prevention of Cisplatin-Induced Hearing Loss: A Systematic Review and Meta-Analysis
title_short Antioxidants in the Prevention of Cisplatin-Induced Hearing Loss: A Systematic Review and Meta-Analysis
title_sort antioxidants in the prevention of cisplatin induced hearing loss a systematic review and meta analysis
topic hearing loss
ototoxicity
supportive care
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1748637
work_keys_str_mv AT richericsoncking antioxidantsinthepreventionofcisplatininducedhearinglossasystematicreviewandmetaanalysis
AT kimberlymaecong antioxidantsinthepreventionofcisplatininducedhearinglossasystematicreviewandmetaanalysis