A pre-planned substudy of RTOG 1016 comparing cetuximab versus cisplatin concurrent with definitive head and neck radiation investigates the trade-off of ototoxicity. Across 335 patients, patient-reported hearing loss was significantly worse following cisplatin versus cetuximab. Approximately 10% of patients developed mild-to-moderate and another 10% severe hearing loss by the end of cisplatin treatment which persisted at one year out, a trend not seen with cetuximab (see figure 2). While not a reason to withhold life-preserving therapy, with 1 in 5 patients potentially impacted, it’s worth bearing in mind: “In clinical practice, comprehensive audiologic ototoxicity monitoring is highly recommended for patients throughout treatment to facilitate patient counseling and aural rehabilitation or potential treatment adjustment.” | Runge, Int J Radiat Oncol Biol Phys 2025
