Background: Platinum compounds are a group of fundamental chemotherapeutics used in the treatment of solid tumors, but they are burdened by side effects, such as ototoxicity. The objective of this study was to evaluate the incidence of ototoxicity caused by platinum compounds and the risk factors affecting its appearance/progression. Methods: Data from 53 patients who received platinum compounds and who had been off therapy for at least 5 years were analyzed. We collected data relating to audiometry conducted annually from the end of treatment and for at least 5 subsequent years, as well as information concerning the oncological history and comorbidities. Results: At the end of the treatment, 17 patients (32.08%) presented ototoxicity, according to the Boston SIOP Ototoxicity Scale; the risk factors included a higher serum creatinine value at diagnosis, having undergone cranial radiotherapy, and needing magnesium supplementation. After 5 years from the end of the treatment, the number of patients with exhibiting ototoxicity was 31 (58.5%); the factors that influenced the onset/progression of the damage were having undergone radiotherapy (HR 1.23; p < 0.01) and having received therapy with aminoglycosides (HR 1.27; p < 0.01). Conclusions: Ototoxicity caused by platinum compounds can occur even after the conclusion of the treatments, and the factors affecting its progression are radiotherapy and the aminoglycosides therapy.
23 April 2026 in Frontiers in Audiology and Otology
Introduction: Posterior inferior cerebellar artery (PICA) strokes often present with acute vestibular symptoms that may mimic peripheral disorders, posing significant diagnostic challenges. Prompt recognition and targeted management are essential to prevent misdiagnosis and improve outcomes. Case description: A 55-year-old woman with acute isolated vertigo showed only a horizontal spontaneous nystagmus, and a diagnosis of stroke on MRI was obtained. Methods: Multiple databases (MEDLINE, EMBASE, Web of Science, Scopus, PubMed, and Cochrane) were searched, using a cutoff date of May 2025, to identify English-language studies on pseudo-vestibular neuritis, which mimic a peripheral disease. We reviewed 112 full-text articles and found 33 reporting data that met the inclusion criteria. Results: We found 79 patients that presented at diagnosis with a spontaneous nystagmus of central origin. Every patient was submitted to MRI and a stroke or infarction was found. The most frequent localization of the lesions was the cerebellum. Discussion: Instrumental oculomotor assessment, in conjunction with advanced neuroimaging techniques, enables early and accurate localization of posterior circulation infarcts.
The aim of the study was to evaluate survival in patients with advanced glottic laryngeal squamous cell carcinoma treated by bioradiotherapy (BioRT) with cetuximab and eventual salvage surgery (group A, n = 66) or upfront surgery (total laryngectomy or near-total laryngectomy) with or without postoperative radiotherapy (PORT) (group B, n = 66). The predictive role of HER1 expression in the bioselection of tumors was evaluated. Relapse-free (RFS), metastasis-free (MFS), overall (OS) survivals, salvageability, and rates of larynx preservation were analyzed. The two groups were balanced by propensity score method on their baseline characteristics. No significant differences in RFS and OS were found, while MFS results were significantly higher in group A (p = 0.04). Group A showed a 22% reduction in the probability of nodal metastasis (p = 0.0023), mostly in tumors with higher HER1 expression. The salvageability with TL at 3 years was 54% after prior BioRT and 18% after prior upfront NTL (p < 0.05). BioRT with cetuximab showed a reduction in the risk of lymph node relapse, particularly in the case of HER1 positive tumors, and it allowed to achieve a higher rate of functional larynx preservation and a higher salvageability compared with upfront surgery. HER1 analysis could be clinically useful in the bioselection of tumors that may benefit from BioRT with cetuximab, particularly in those with neck node metastatic propensity.