About this trial
This clinical trial tests the impact of offering hearing tests (audiometry) close to home and remotely on participation in monitoring for treatment-related hearing loss in patients with head and neck squamous cell cancer receiving cisplatin and/or radiation. Cisplatin, a chemotherapy often used to treat head and neck cancers, and radiation given near the ear can cause hearing loss in some patients. Hearing loss can have a major negative impact on quality of life, contributing to social isolation and frustration. Identifying hearing changes may allow treatment changes to prevent further loss. Audiometry measures hearing loss using a graphic record of the softest sounds that a person can hear at various frequencies. It is recommended patients have a hearing test before, during and after treatment to monitor for any hearing loss. This is usually done in the office and performed on the same day as other visits whenever possible, however, patients who live far away or have stage IV cancer, may have more difficulty coming back for hearing tests. Offering close to home and remote audiometry may improve monitoring for hearing loss in patients with head and neck squamous cell cancer receiving cisplatin and/or radiation.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Adult patients, male or female, aged ≥ 18, able to provide informed consent
Subjects with pathologically proven HNSCC involving the oral cavity, oropharynx, larynx, hypopharynx, nasopharynx, skin, or paranasal sinuses; patients with unknown primary HNSCC involving the cervical lymph nodes can also be included. Patients can have previously untreated or recurrent/metastatic disease
Subjects who will be treated with cisplatin chemotherapy and/or radiation. For radiation alone, patients should have tumors near the inner ear, including the nasopharynx, temporal bone, and/or parotid salivary gland
Life expectancy of more than 3 months, as determined by the investigator
Disqualifiers
Patients with profound hearing loss in both ears, which precludes an accurate hearing test. This can be determined based on patient report/history or audiogram done before or after informed consent
Patients who are unable to participate in a hearing test (per the investigator's judgment)
Trial design
Parallel
Treatments tested in this trial
Audiometric Test
Procedure/SurgeryUndergo audiometry
Audiometric Test
Procedure/SurgeryUndergo close to home audiometry
Audiometric Test
Procedure/SurgeryUndergo self-administered remote audiometry
Interview
Other interventionAncillary studies
Treatment groups
Trial outcomes
Primary outcomes
Proportion of patients who complete at least one post-treatment audiogram
The incidence of follow-up audiometry relative to the targeted intervention will be assessed using a Z test for the equality of two proportions. An ordinal logistic regression analysis with mixed effects and calculations of odds ratios and 95% confidence intervals will be applied to identify associations between follow-up audiometry and intervention after adjustment for covariates including age, sex, race/ethnicity, pre-existing hearing loss, comorbidities, smoking, cisplatin dose (individual and cumulative) and cochlear radiation dose will be performed to assess whether the targeted intervention for at-risk patients is an independent predictor of increased overall participation.
Secondary outcomes
Incidence and severity of hearing loss
Assessed using Common Terminology Criteria for Adverse Events criteria and American Speech Language and Hearing Association criteria.
Other outcomes
To identify potential barriers to ototoxicity monitoring participation
Qualitative data from patient interviews focused on barriers to ototoxicity monitoring.
Sponsors and contacts
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Emory University
Lead sponsor
National Cancer Institute (NCI)
Collaborator
National Institute on Deafness and Other Communication Disorders (NIDCD)
Collaborator