Journal: Animal models and experimental medicine
This review article focuses on cochleovestibular toxicity as a major, often under-recognized late effect of cancer treatment.
Key points:
- Clinical impact: Ototoxicity from cancer therapies leads to sensorineural hearing loss and vestibular dysfunction, with downstream effects on cognition and long-term quality of life in survivors.
- Causative treatments:
- – Platinum-based chemotherapy, especially cisplatin
- – Radiotherapy involving the temporal bone/inner ear
- – Emerging immunotherapies are also implicated, though data are more limited.
- Mechanisms:
- – Detailed emphasis on cisplatin-induced, largely irreversible damage to the stria vascularis and cochlear hair cells.
- – Damage is multifactorial and involves complex molecular pathways within the inner ear.
- Risk factors:
- – Age (both pediatric and older adults are highlighted as vulnerable groups).
- – Specific genetic polymorphisms that may modify susceptibility.
- – Cumulative drug dose and treatment intensity.
- Monitoring gaps:
- – Current clinical protocols for detecting ototoxicity are judged inadequate.
- – The authors advocate routine baseline audiologic assessment and high-frequency audiometry as standard of care for patients receiving ototoxic cancer therapies.
- Management and prevention:
- – Review of existing otoprotective strategies and rehabilitative options, including cochlear implants.
- – Overview of investigational otoprotective agents and novel therapeutics in preclinical development.
- Overall message: The article calls for a precision-medicine strategy that integrates molecular risk profiling, rigorous audiologic monitoring, and tailored otoprotective interventions to maintain oncologic efficacy while preserving auditory and vestibular function in cancer survivors.