SLPNarrative ReviewEar and hearing2024

Roadmap to a Global Template for Implementation of Ototoxicity Management for Cancer Treatment.

Katharine Fernandez, Alex Hoetink, Dawn Konrad-Martin and 19 others

PMID 39261989

WHAT IT FOUND

Ototoxicity in cancer survivors is often overlooked, leaving patients with unexpected permanent hearing loss and tinnitus.

Experts propose a global roadmap for standardized monitoring, patient education, and workforce training to integrate hearing care into oncology pathways.

Key findings

01Ototoxic adverse events are neither commonly assessed nor managed, leading to survivors experiencing unexpected permanent hearing loss and tinnitus.

02Current patient-reported outcome measures like PRO-CTCAE capture dizziness and tinnitus but fail to include questions about hearing loss or trouble understanding speech in noise.

03There is a significant disparity in audiologist availability globally, with 78% of WHO African Region countries having fewer than one audiologist per one million population.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

This is an expert opinion and roadmap, not a study with patient data or clinical outcomes. The authors acknowledge that there are no studies yet evaluating how modifications in platinum treatment based on early detected audiogram changes influence hearing outcomes. The roadmap is based on a converged understanding by international experts, which may reflect specific institutional or regional biases rather than universal applicability. The authors state that the assumption that earliest detection of ototoxicity improves quality of life requires further exploration.

Declared interests

Financial disclosures and conflicts of interest are reported by some authors, including roles in the IOMG Ototoxicity of Cancer Treatment Focus Area, patents related to ototoxicity monitoring, and industry-sponsored research contracts from companies like Otonomy Inc., Frequency Therapeutics, and Oticon Medical.

The easy way to misread this

Do not interpret this roadmap as evidence that the proposed monitoring strategies have been proven to improve patient outcomes. The authors explicitly state that further exploration is needed to establish if ototoxicity management strategies result in earlier intervention and improvements to quality of life.

Read it on PubMed →