Ototoxicity Monitoring: The Evolution of a Protocol for Head and Neck Cancer Patients

Monday, September 30, 2024

1:36 PM – 1:42 PM EDT

Location: MBCC, 208

Disclosure(s):

Jena C. Patel, MD:

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

Molly M. Wolfson, AuD:

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

Zachary D. Urdang, MD, PhD:

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

Jacob B. Hunter, MD:

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

Introduction: We aim to evaluate an audiologist-driven ototoxicity monitoring program (OTM) as a part of a comprehensive tumor board for improving audiologic follow-up in head and neck cancer (HNC) patients.

Methods: This was retrospective cohort study conducted at a tertiary academic center. In total, 516 patients were recommended for chemotherapy by our tumor board between January 2017 and June 2022. Patients were divided into pre-OTM and post-OTM cohorts. OTM was implemented in March 2021; every patient recommended for chemotherapy automatically received an audiology referral and was contacted to schedule a baseline audiogram. Outcome measures included rates of insurance benefit verification to qualify for an audiogram, baseline audiograms, posttreatment audiograms, and identification of pretreatment hearing loss.

Results: There were 258 patients in both cohorts. Mean age for all patients was 65 ± 11.7 years; there were 382 males (74%). Insurance benefits were verified in 56 (21.7%) of the pre-OTM patients and 154 (59.7%) of the post-OTM patients (p < 0.001). A total of 66 patients (25.6%) underwent a baseline audiogram in the pre-OTM cohort vs 91 patients (35.3%) in the post-OTM cohort (p = 0.017); patients with insurance verification had higher rates of baseline audiograms in both cohorts (p < 0.001). Baseline hearing loss was identified in 61/66 (92.4%) of pre-OTM patients and 68/91 (74.7%) of post-OTM patients (p = 0.004). Post-treatment audiogram was done in 28 patients (10.8%) in the pre-OTM group and 25 patients (9.6%) in the post-OTM cohort (p>0.05).

Conclusions: Implementation of OTM significantly improved the proportion of HNC patients that underwent baseline audiograms prior to systemic therapy; however, audiologic follow-up remained low during the posttreatment period.

Presenting Author(s)

JP

Jena C. Patel, MD

Resident
Thomas Jefferson University Department of Otolaryngology
Philadelphia, PA, United States

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

Co-Author(s)

Julia B. Croce, AuD

Director of Audiology
Thomas Jefferson University
Philadelphia, PA, United States

Disclosure information not submitted.
MW

Molly M. Wolfson, AuD

Audiologist
Thomas Jefferson University Hospital
Margate, NJ, United States

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

Jacob Hulswit, AuD

Thomas Jefferson University Hospital, United States

Disclosure information not submitted.
Zachary D. Urdang, MD, PhD

Postdoc
University of Iowa
Flagstaff, AZ, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Jacob B. Hunter, MD

Associate Professor
Thomas Jefferson University Hospitals
Philadelphia, PA, United States

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

Senior Author(s)

IM

Irina Middleton, AuD

Thomas Jefferson University Hospital, United States

Disclosure information not submitted.