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Cisplatin Ototoxicity — SCE Medical Oncology MCQ

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EasyOncological EmergenciesCisplatin OtotoxicitySCE Medical Oncology

A 55-year-old woman receiving cisplatin-based chemotherapy for ovarian cancer develops tinnitus and reduced hearing acuity. Audiometry confirms bilateral high-frequency sensorineural hearing loss. What is the recommended management?

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Correct answer: A — Substitute cisplatin with carboplatin for subsequent cycles to preserve remaining hearing

Cisplatin ototoxicity is cumulative, dose-dependent and irreversible, typically affecting high-frequency hearing first (4-8 kHz). Once symptomatic hearing loss develops, cisplatin should be substituted with carboplatin (which has significantly less ototoxicity) for subsequent cycles. No otoprotective agents are established in adults (sodium thiosulfate is approved for paediatric use only). Baseline and serial audiometry is recommended during cisplatin treatment.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer