Long-term ototoxicity in women after cisplatin treatment for ovarian germ cell cancer

Gynecol Oncol. 2017 Apr;145(1):148-153. doi: 10.1016/j.ygyno.2017.02.006. Epub 2017 Feb 12.


Objective: Evaluate long-term cisplatin-induced ototoxicity in women treated for malignant ovarian germ cell tumors (MOGCT).

Methods: Seventy-four women treated for MOGCT in Norway (1980-2009) were analyzed: 41 had received cisplatin-based chemotherapy (CBCT) ("Cases") and 33 had no CBCT ("Controls"). Median follow-up was 15years. Hearing was assessed by pure tone audiometry and by the SCIN questionnaire. Air conduction thresholds were reported as absolute hearing thresholds and age-adjusted thresholds. Absolute and age-adjusted hearing loss were defined as thresholds of >20dB at any frequency. Tinnitus was evaluated using the Tinnitus Handicap Inventory. Serum Platinum Concentration (SPC) was determined.

Results: Absolute hearing loss was identified in 21 Cases (51%) and 24 Controls (73%). After adjusting for age, only 9 Cases (22%) and 5 Controls (15%) remained. Age-adjusted hearing thresholds at 4, 6 and 8kHz were slightly but significantly higher in Cases compared to Controls. Subjective hearing loss was reported by 27% of Cases and 21% of Controls, who were significantly older. Elevated SPC values were detected up to 20years after CBCT, but SPC did not correlate significantly with age-adjusted hearing loss. The rate of tinnitus was similar in Cases and Controls.

Conclusion: Long-term MOGCT survivors treated with CBCT have small but significant reductions in age-adjusted hearing thresholds at 4, 6 and 8kHz versus Controls. Approximately one in four women experienced subjective hearing loss. To avoid overestimation of clinically relevant cisplatin-induced ototoxicity, absolute hearing thresholds should be age-adjusted and compared to an age-matched control group.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Audiometry, Pure-Tone
  • Bleomycin / administration & dosage
  • Case-Control Studies
  • Chemotherapy, Adjuvant
  • Child
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects*
  • Etoposide / administration & dosage
  • Female
  • Hearing Loss / blood
  • Hearing Loss / chemically induced*
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Neoplasms, Germ Cell and Embryonal / drug therapy*
  • Ovarian Neoplasms / drug therapy*
  • Ovariectomy*
  • Platinum / blood
  • Vinblastine / administration & dosage
  • Young Adult


  • Bleomycin
  • Platinum
  • Vinblastine
  • Etoposide
  • Cisplatin

Supplementary concepts

  • Ovarian Germ Cell Cancer