Docetaxel
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Ototoxicity: 2 case reports A 58-year-old woman and a 74-year-old woman developed ototoxicity during treatment with docetaxel for invasive ductal breast cancer [not all times to reaction onsets not stated]. Case 1: The 58-year-old postmenopausal woman was diagnosed with a low differentiated breast carcinoma in March 2013 and received 4 cycles of neoadjuvant chemotherapy with docetaxel and pirarubicin. She underwent a modified radical mastectomy on 26 September 2013. Postoperative pathology showed invasive ductal carcinoma and she underwent left axillar lymphadenectomy and lymph node metastatic carcinoma was observed. Further, she received postoperative radiotherapy. During radiotherapy, she received endocrine therapy with exemestane. On 10 February 2017, she experienced pain in the left rib and investigations confirmed rib metastases. She switched to toremifene therapy from exemestane. Two months later, her bone metastases progressed. On 21 April 2017, salvage treatment with 8 cycles of IV docetaxel 67 mg/m2 on day 1 of a 3-week cycle was initiated. On 9 December 2017 (i.e., after the second day of the eighth cycle of docetaxel), she experienced buzzing and whistling in both ears and reduced hearing perception. She then underwent ENT examination due to worsening of above-mentioned symptoms. Eventually, she was diagnosed with sensorineural hearing loss, inner ear microcirculation obstruction and peripheral neuritis. Cerebral MRI and otomicroscopic examination revealed no abnormal findings. Pure tone audiometry revealed bilateral sensorineural hearing loss. She was then prescribed unspecified neurotrophic drug treatment. Subsequently, deafness symptoms showed partial improvement. Several additional pure tone audiometry tests did not show significant improvement in her symptoms of deafness. Her hearing was normal before docetaxel treatment. Based on above-mentioned findings, she was diagnosed with ototoxicity induced by docetaxel. Due to damage to the sensorineural structure of the inner ear is irreversible, symptoms of hearing loss did not recede with docetaxel discontinued. Case 2: A 74-year-old woman, who was admitted with a tumour of the left breast in July 2013, immediately underwent a modified radical mastectomy. Postoperative pathology showed invasive ductal carcinoma. Between 30 September 2013 and 2 December 2013, she received postoperative adjuvant chemotherapy, comprising pirarubicin combined with cyclophosphamide. Thereafter, on 30 December 2013, she received 1 cycle of IV docetaxel infusion 75 mg/m2 on day 1 of a 3-week cycle chemotherapy. Two days after first cycle of docetaxel, she experienced significant hearing loss in bilateral ears. She had no hearing loss symptoms prior to docetaxel. She had not received other ototoxic drugs during docetaxel treatment. Thus, it was considered that the hearing loss was caused by the infusion of docetaxel. ENT examination revealed binaural sensorineural hearing loss with perforation of the left eardrum. She was eventually diagnosed with ototoxicity induced by doc
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