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Scientific Oral Presentations

Otology/Neurotology

Session: Scientific Oral Presentations 8 - Otology/Neurotology

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

Tuesday, October 1, 2024
11:30 AM – 11:36 AM EDT
Location: MBCC, 231
Disclosure(s):
Jaime Plane, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Thamiris D.D Cabral, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Joao E. P Conrado, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Bruno D.V Vendramini:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

David H. Jung, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Cisplatin is a highly effective antineoplastic drug used worldwide in a variety of malignancies. However, it is associated with severe side effects such as cisplatin-induced hearing loss (CIHL), a permanent and debilitating disability. N-acetylcysteine (NAC) has been suggested as a promising drug to prevent or reduce cisplatin-derived ototoxicity. Therefore, we conducted a systematic review and meta-analysis to assess the efficacy of NAC in preventing CIHL.

Methods: Articles reporting the administration of systemic or intratympanic injection of NAC for cisplatin-induced hearing loss prevention were searched in PubMed, Embase, Web of Science, clinicaltrials.gov, and Cochrane Library. The outcomes of interest included presence of hearing loss and changes in hearing thresholds at 0.5 kHz through 12 kHz.

Results: A total of 7 studies involving 233 patients were included, of which 180 received systemic NAC, and the remaining intratympanic injection. No significant differences were found between use of either systemic or intratympanic NAC administration compared to placebo for CIHL prevention (Risk ratio [RR] 0.8; 95% confidence interval [CI] 0.52-1.24; p = 0.31, and RR 0.37; 95% CI 0.03-3.99; p = 0.41, respectively). No significant differences were found at 0.5 kHz to 8 kHz between groups. Conversely, changes in 10 kHz to 12 kHz were significantly more severe in the placebo group compared to systemic NAC (Mean difference [MD] -11.08 dB; 95% CI -14.95,-7.22; p < 0.00001, and MD -11.22 dB; 95% CI -15.19,-7.24; p < 0.00001, respectively).

Conclusions: Our findings suggest that, regardless of administration route, NAC is not effective to prevent CIHL in the standard clinical audiogram range. However, its systemic use may reduce the severity of hearing loss at ultra high frequencies. Further studies with larger samples are needed to confirm our findings.

    Presenting Author(s)

  • Jaime Plane, MS

    Medical Student
    University of Chile
    Santiago, Region Metropolitana, Chile

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Thamiris D.D Cabral, MD

    Resident
    Federal Hospital of Bonsucesso
    Rio de Janeiro, Rio de Janeiro, Brazil

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Renata M. Knoll, MD

    Otolaryngology H&N Surgery Resident
    Massachusetts Eye and Ear
    Boston, MA, United States

    Disclosure information not submitted.

  • Joao E. P Conrado, MS

    Medical Student
    Federal University of Ceará
    Fortaleza, Ceara, Brazil

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Bruno D.V Vendramini

    Medical Student
    Federal University of São João del Rei
    São José do Rio Preto, Sao Paulo, Brazil

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • DJ

    David H. Jung, MD, PhD

    Assistant Professor
    Massachusetts Eye and Ear Infirmary/Harvard Medical School
    Boston, Massachusetts, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.