The Effectiveness of Steroids and Antioxidants in the Management of Cisplatin-induced Ototoxicity: A Comprehensive Systematic Review of the Literature and Network Meta-Analysis
Bibliographic record
Abstract
Abstract Background: Cisplatin efficacy in cancer therapy is hindered by dose-dependent toxicities, including ototoxicity. Its mechanisms involve cochlear damage and oxidative stress. Gender and age affect susceptibility, with limited treatment options for adults. Objective: To assess the effectiveness of steroids compared to antioxidants (AOs) in preventing and managing cisplatin-induced ototoxicity. Materials and Methods: Data were collected from multiple sources including Medline, CENTRAL, PubMed, and Springer Nature Journals. Adults and pediatrics with the clinical diagnosis of cisplatin-induced ototoxicity, interventional studies (including single-arm studies) were included. Studies with a focus on chemotherapy agents other than cisplatin were excluded. Results: The study encompassed 10 randomized controlled trials spanning 2004–2023 across Canada, Israel, The Netherland, Spain, Turkey, Greece, Italy, and Iran. It aimed to evaluate interventions for preventing cisplatin-induced ototoxicity, including intratympanic injections and oral dietary supplements. Based on the results of this systematic review, thiosulfate-hyaluronate gel showed a 1.3 dB reduction in hearing loss; dexamethasone injections had minimal efficacy; L-N-acetylcysteine (L-NAC) offered significant otoprotection with daily infusion; and transtympanic L-NAC showed no significant benefit. Salicylate usage yielded no decrease in hearing loss. AO dietary supplements showed no difference in results between groups. However, based on the network meta-analysis results, it appears that steroids perform best in reducing cisplatin-induced ototoxicity at higher frequencies (8000 Hz), followed by placebo and then AO. Conclusion: A further molecular and targeted therapy is needed to target the cyto/ototoxic activity and further prevent such deterioration in hearing and promote chemotherapy regime without ototoxic effects.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".