Self-Perceived Hearing Outcomes With Radiation and Cisplatin or Radiation and Cetuximab for Patients With Human Papilloma Virus (HPV)-Positive Oropharyngeal Cancer-Results From NRG Oncology RTOG 1016
Recommended Citation
Runge CL, Lyness JA, Gillison ML, Adelstein DJ, Harari PM, Ringash J, Geiger JL, Krempl GA, Blakaj DM, Bates JE, Galloway TJ, Jones CU, Gensheimer MF, Dunlap NE, Phan J, Caudell JJ, Pennington JD, Torres-Saavedra PA, Yom SS, Le QT, and Movsas B. Self-Perceived Hearing Outcomes With Radiation and Cisplatin or Radiation and Cetuximab for Patients With Human Papilloma Virus (HPV)-Positive Oropharyngeal Cancer-Results From NRG Oncology RTOG 1016. Int J Radiat Oncol Biol Phys 2025.
Document Type
Article
Publication Date
8-18-2025
Publication Title
Int J Radiat Oncol Biol Phys
Abstract
PURPOSE: RTOG 1016 was a noninferiority phase 3 trial comparing the efficacy of radiation with either cisplatin (RT + Cis) or cetuximab (RT + Cetux) for patients with Humman Papillomavirus (HPV)+ oropharyngeal cancer (OPC). Perceived hearing handicap was included as a patient-reported outcome (PRO) secondary endpoint. The primary hypothesis was that perceived hearing handicap would be greater for patients receiving RT + Cis compared with RT + Cetux.
METHODS AND MATERIALS: Perceived hearing handicap was measured at baseline, end of treatment, and 3, 6, and 12 months posttreatment using the Hearing Handicap Inventory for Adults Screening Version (HHIA-S), a 10-item self-assessment questionnaire designed to measure patients' reactions to their hearing loss. Mixed ordinal logistic models were used to determine the treatment effect on HHIA-S scores and handicap categories (2-sided α = 0.05).
RESULTS: The PRO substudy included 375 eligible patients. No significant differences in patient/tumor characteristics were found between patients who participated in the HHIA-S study versus those excluded. For total HHIA-S scores and social and emotional subscales, RT + Cetux had significantly lower (ie, better) scores from end of treatment. Change score from baseline to end of treatment for RT + Cis (4.32; 95% confidence interval [CI], 2.57-6.07]) was greater than RT + Cetux (0.08; 95% CI, -1.15 to 1.31). For hearing handicap category, RT + Cis had a significantly higher percentage of mild/moderate and severe cases at the end of treatment (32%) compared with RT + Cetux (20%) (P < .0001). Adjusted conditional odds of higher self-perceived hearing handicap category for RT + Cis compared with RT + Cetux was 3.73 (95% CI, 2.10-6.62).
CONCLUSION: Patients have significantly worse self-perceived hearing handicap after receiving RT + Cis treatment than with RT + Cetux. This was consistent across time through 1 year posttreatment. These findings inform hearing-related outcomes for patients with HPV-associated OPC and indicate the need for ototoxicity monitoring with RT + Cis treatment.
PubMed ID
40829719
ePublication
ePub ahead of print
