Evidence map›Paper›PMID 40323204›Full record

SynthesisOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery2025

N-acetylcysteine for the Prevention of Cisplatin-Induced Hearing Loss: A Systematic Review and Meta-analysis.

Jaime Plane, Thamiris D D Cabral, Renata M Knoll, João E P Conrado, Bruno D V Vendramini, David H Jung

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jaime PlaneDepartment of Medicine, University of Chile Medical School, Santiago, Chile.
Thamiris D D CabralDepartment of Otolaryngology-Head and Neck Surgery, Federal Hospital of Bonsucesso, Rio de Janeiro, Brazil.
Renata M KnollDepartment of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.
João E P ConradoDepartment of Medicine, Federal University of Ceará Medical School, Fortaleza, Brazil.
Bruno D V VendraminiDepartment of Medicine, Federal University of São João del Rei, São João del Rei, Minas Gerais, Brazil.
David H JungDepartment of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.

Funding

RESEARCH TRAINING IN OTOLARYNGOLOGYT32DC000020 · NIDCD · MASSACHUSETTS EYE AND EAR INFIRMARY · PI JUNG, DAVID H, SIMONYAN, KRISTINA · 1990 to 2025
$2.4M
NIDCD NIH HHS T32 DC000020
6 · The paper itself

Abstract

objectiveCisplatin is an effective antineoplastic drug used worldwide in the treatment of various malignancies. However, it is associated with side effects, including cisplatin-induced hearing loss (CIHL). N-acetylcysteine (NAC) has been suggested as a promising drug to prevent or reduce cisplatin-derived ototoxicity. To evaluate the evidence supporting the efficacy of NAC in preventing CIHL, we conducted a systematic review and meta-analysis of the literature. DATA SOURCES: A systematic search was conducted on PubMed, Embase, Web of Science, Clinicaltrials.gov, and Cochrane Library. REVIEW

methodsArticles reporting the administration of systemic or transtympanic injection of NAC for CIHL prevention were considered. The outcomes of interest included the presence of hearing loss events and changes in hearing thresholds at 0.5 through 12 kHz following cisplatin treatment.

resultsA total of 7 studies involving 217 patients met inclusion criteria. Of these patients, 175 received systemic administration of NAC, and the remaining received transtympanic injection of NAC. No significant differences were found in CIHL prevention between the use of either systemic or transtympanic NAC administration compared to placebo (risk ratio [RR] 0.80; 95% confidence interval [CI] 0.54-1.19; P = .28, and RR 0.89; 95% CI 0.51-1.54; P = .67, respectively). No significant differences were found at 0.5 to 8 kHz between groups. Qualitative analyses suggested a tendency to otoprotection in ultra-high frequencies (10 and 12 kHz).

conclusionOur findings suggest that, regardless of administration route, current published evidence does not show that NAC is effective in preventing CIHL in the standard clinical audiogram range. Further studies with larger samples are needed to confirm our findings. LEVEL OF EVIDENCE: I.

Indexed as

AcetylcysteineAntineoplastic AgentsCisplatinHearing LossHumansOtotoxicityAcetylcysteineAntineoplastic AgentsCisplatincisplatin‐induced hearing lossN‐acetylcysteineotoprotectionototoxicity

Identifiers

PMID40323204
PMCPMC13095053

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.