A Prospective Multicenter Observational Study Investigating the Concordance Between Patient-Reported Hearing Loss and Commonly Used Ototoxicity Grading Systems in Patients Treated with Platinum-Based Chemotherapy

Purpose: This study aims to compare the accuracy of the TUNE, American Speech-Language-Hearing Association (ASHA), and Common Terminology Criteria for Adverse Events (CTCAE) grading systems in reflecting the severity of treatment-related hearing loss, as measured by pure-tone audiometry and patient-reported hearing loss using the Speech, Spatial, and Qualities of Hearing scale compare questionnaire (SSQ). Methods: This study is a prospective, multicenter, cross-sectional, and observational study from 2018 to 2024 conducted at the Netherlands Cancer Institute - Antoni van Leeuwenhoek Amsterdam, Leiden University Medical Center, and University Medical Center Utrecht. In this trial, 109 patients with an indication for curative platinum-based chemotherapy (dose ≥ 200 mg/m 2 ) were included, of whom 74 were eligible for analysis. Standard frequency and extended high-frequency pure tone audiometry were measured at baseline and follow-up. The SSQ was administered at follow-up to assess patient-reported outcome measures for hearing loss. The TUNE, ASHA, and CTCAE criteria were derived from audiometry. Concordance and Spearman’s correlations were evaluated between all 3 grading systems and the SSQ. Results: The concordance of TUNE with the SSQ was 81%. The concordance of CTCAE and ASHA with the SSQ was 73% and 68%, respectively. A statistically significant Spearman’s correlation coefficient of −.35 ( P = .01) was found between TUNE and the SSQ. The Spearman’s correlation coefficient with CTCAE or ASHA and SSQ was −.10 ( P = .10) and .04 ( P = .75), respectively. Conclusion: This study found that the TUNE is better in reflecting platinum-related patient-reported hearing loss compared to the CTCAE and ASHA.