Monitoring of vestibular function during cisplatin therapy

ABSTRACT

Cisplatin is considered an indispensable chemotherapeutic agent inspite of its known ototoxicity. There is no generally accepted vestibular monitoring protocol that is efficient, cost effective and suitable for patients treated with cisplatin. The aim of this work was to study the vestibulo-ocular reflex [VOR] changes in an attempt for early identification and prevention of vestibular toxicity in patients receiving cisplatin chemotherapy. The final study group consisted of 39 patients. The pretherapy vestibular tests included electronystagmography and rotary chair tests which should be within normal. The vestibular monitoring procedure was scheduled one week after each cisplatin dose. Patients were re-evaluated at approximately 3 months after termination of therapy to assess the possible delayed residual effects [delayed ototoxicity or recovery patients]. After the first cisplatin dose, seven patients revealed bilateral canal paresis, reduced total eye speed and reduction in VOR gain at 0.01 and 0.02Hz. With successive cisplatin doses, the VOR gain showed significant reduction at higher frequencies. Three months after termination of therapy canal paresis and total eye speeds showed no change in the measured values. On the other h and, VOR gain was relatively improved