Evidence map›Paper›PMID 41122972›Full record

ArticleJCI insight2025

Lower, more frequent cisplatin dosing minimizes hearing loss in head and neck cancer.

Katharine A Fernandez, Abu S Chowdhury, Amanda Bonczkowski, Paul D Allen, Maura H Campbell, David S Lee, Charvi Malhotra, Brandi R Page, Deborah A Mulford, Candice Evita Ortiz and 6 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in JCI insight, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
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

16 authors.

Katharine A FernandezNational Institute on Deafness and Other Communication Disorders, Bethesda, Maryland, USA.
Abu S ChowdhuryNational Institute on Deafness and Other Communication Disorders, Bethesda, Maryland, USA.
Amanda BonczkowskiNational Institute on Deafness and Other Communication Disorders, Bethesda, Maryland, USA.
Paul D AllenDepartment of Otolaryngology, University of Rochester Medical Center, Rochester, New York, USA.
Maura H CampbellDepartment of Otolaryngology, University of Rochester Medical Center, Rochester, New York, USA.
David S LeeDepartment of Otolaryngology - Head and Neck Surgery, Washington University in St. Louis, St. Louis, Missouri, USA.
Charvi MalhotraStanford University, Division of Oncology, Stanford, California, USA.
Brandi R PageDepartment of Radiation Oncology and Molecular Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Deborah A MulfordWilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA.
Candice Evita OrtizCapital Institute of Hearing and Balance, Silver Spring, Maryland, USA.
Peter L Santa MariaDepartment of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Peter KullarManchester Foundation Trust, Manchester, United Kingdom.
Saad A KhanStanford University, Division of Oncology, Stanford, California, USA.
Shawn D NewlandsDepartment of Otolaryngology, University of Rochester Medical Center, Rochester, New York, USA.
Nicole C SchmittDepartment of Otolaryngology - Head and Neck Surgery, Emory University, Atlanta, Georgia, USA.
Lisa L CunninghamNational Institute on Deafness and Other Communication Disorders, Bethesda, Maryland, USA.

Funding

Mechanisms of Sensory Hair Cell Survival and DeathZIADC000079 · NIDCD · NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS · PI CUNNINGHAM, LISA L · 2011 to 2025
$27.2M
Intramural NIH HHS ZIA DC000079
6 · The paper itself

Abstract

BACKGROUNDCisplatin is often the cytotoxic drug of choice for chemoradiation therapy (CRT) for head and neck squamous cell carcinoma (HNSCC), but it can lead to irreversible hearing loss. There may be similar oncologic outcomes but different toxicity profiles depending on whether cisplatin is given at 75-100 mg/m2 every 3 weeks or 30-40 mg/mg2 weekly. This study compares cisplatin-induced hearing loss in patients with HNSCC receiving similar cumulative doses of cisplatin administered either on higher-dose or lower-dose treatment schedules.METHODSUsing the Enhancing Cancer Hearing Outcomes (ECHO) dataset from 5 academic centers, we conducted a multicenter retrospective cohort study of adults (≥18 years) with HNSCC receiving cisplatin-based CRT. Participants were grouped by cisplatin dose schedule: every 3 weeks (≥75 mg/m²) or weekly (<75 mg/m²). Hearing loss was assessed using American Speech-Language-Hearing Association (ASHA) and Common Terminology Criteria for Adverse Events (CTCAE) v5.0 threshold shift criteria based on audiograms obtained ≤120 days before and after treatment. Risk differences and predictors of hearing loss were evaluated using χ2 analyses and multivariate regression. Kaplan-Meier curves assessed overall and disease-free survival.RESULTSAmong 564 participants (1,127 ears), lower-dose weekly cisplatin was associated with significantly lower incidence of hearing loss (ASHA criteria: 57% vs. 82%; CTCAE criteria: 39% vs. 69%). CTCAE grade ≥2 hearing loss occurred in 18% of the weekly group versus 50% of the 3-week group. Multivariate analysis confirmed treatment schedule as an independent predictor of ototoxicity. Two-year survival outcomes did not differ between groups.CONCLUSIONSWeekly low-dose cisplatin significantly reduced the incidence and severity of hearing loss without compromising survival, supporting its broader use in CRT for HNSCC.

Indexed as

Antineoplastic AgentsCisplatinHead and Neck NeoplasmsHearing LossSquamous Cell Carcinoma of Head and NeckAdultAgedChemoradiotherapyDose-Response Relationship, DrugDrug Administration ScheduleFemaleHumansKaplan-Meier EstimateMaleMiddle AgedRetrospective StudiesAntineoplastic AgentsCisplatinClinical practiceClinical ResearchHead and neck cancerOncologyOutcomes research

Identifiers

PMID41122972
PMCPMC12581672

What OpenQuestion holds

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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.