高剂量卡铂是治疗先前治疗过的生殖细胞瘤（GCTs）患者的根治性高剂量化疗（HDCT）的重要组成部分。虽然听力损失（HL）是HDCT已知的副作用，但关于其严重程度和特征的数据有限。从1993年至2017年，符合条件的患者接受了GCTs的HDCT，并在HDCT前后进行了听力图。根据美国言语-语言-听力协会标准对HL严重程度进行了分类，并估计了每个频率（0.25-8 kHz）的听力阈值在HDCT前后和HDCT周期之间的平均变化。在115名患者（中位年龄32岁）中，有102名（89%）接受了三个HDCT周期。在106名在HDCT前言语频率（0.5-4 kHz）正常听力到轻度HL的患者中，有70名（66%）在HDCT后言语频率中发展为中度至深度HL。25名患者（22%）在HDCT后被建议佩戴助听器。在HDCT之前，仅存在于较高频率（6-8 kHz）的中度至深度HL的患者，在HDCT后更有可能在言语频率中发展为中度至深度HL（94% vs. 61%；p = .01），并需要建议佩戴助听器（39% vs. 18%；p = .05）。HDCT后HL频率较高，绝大多数患者在言语频率中发展至少中度的HL，并有约五分之一的患者需要听力助听器。基线时仅存在于高频率的中度至深度HL可预测HDCT后更临床显著的听力损失。一些患有生殖细胞瘤的患者，这是青少年和年轻成年男性最常见的恶性肿瘤，无法通过标准剂量化疗治愈，需要进行高剂量化疗（HDCT）。通过对接受HDCT的患者的详细听力评估，我们发现大多数患者出现了明显的听力损失，其中五分之一需要佩戴助听器。因此，迫切需要采取策略减少这种副作用，并建议所有接受HDCT的患者在疗程结束后进行听力测试。© 2023年美国癌症协会。

High-dose carboplatin is an essential part of curative high-dose chemotherapy (HDCT) for patients with previously treated germ cell tumors (GCTs). Although hearing loss (HL) is a known side effect of HDCT, data on its severity and characteristics are limited.Eligible patients received HDCT for GCTs from 1993 to 2017 and had audiograms before and after HDCT. HL severity was classified by American Speech-Language-Hearing Association criteria, and mean change in hearing threshold at each frequency (0.25-8 kHz) was estimated from pre- to post-HDCT and between HDCT cycles.Of 115 patients (median age, 32 years), 102 (89%) received three cycles of HDCT. Of 106 patients with normal hearing to mild HL in the speech frequencies (0.5-4 kHz) before HDCT, 70 (66%) developed moderate to profound HL in the speech frequencies after HDCT. Twenty-five patients (22%) were recommended for hearing aids after HDCT. Patients with moderate to profound HL isolated to the higher frequencies (6-8 kHz) before HDCT were more likely to develop moderate to profound HL in the speech frequencies after HDCT (94% vs. 61%; p = .01) and to be recommended for hearing aids (39% vs. 18%; p = .05).HL was frequent after HDCT for GCTs, with most patients developing at least moderate HL in the speech frequencies and approximately one in five recommended for hearing aids. Moderate to profound HL isolated to high frequencies at baseline was predictive of more clinically significant hearing impairment after HDCT.Some patients with germ cell tumors, the most common malignancy in adolescent and young adult men, are not cured with standard-dose chemotherapy and require high-dose chemotherapy (HDCT). Using detailed hearing assessments of patients receiving HDCT, we found that most patients developed significant hearing loss and that one in five needed hearing aids. Thus, strategies to reduce this side effect are urgently needed, and all patients receiving HDCT should have a hearing test after therapy.© 2023 American Cancer Society.