Sensorineural hearing outcomes in HPV-positive oropharyngeal cancer: a secondary analysis of the TROG 12.01 randomized trial (SHOUT)

Abstract

Purpose: Cisplatin-associated deterioration in sensorineural hearing thresholds is an important survivorship concern in HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). Weekly low-dose cisplatin may reduce ototoxicity compared with high-dose schedules, but randomized audiometric data are limited. This secondary analysis of TROG 12.01 compared hearing outcomes between weekly cisplatin + radiotherapy (RT) and cetuximab + RT. Methods: Audiometric data were available for 101 TROG 12.01 trial participants. Patients received 70 Gy in 35 fractions with either weekly cisplatin (40 mg/m2, n = 55) or cetuximab (400 mg/m2 loading, then 250 mg/m2 weekly, n = 46). Pure-tone audiometry (500–800..