How should cisplatin be used in head and neck cancer patients with sensorineural hearing loss?  

I generally avoid cisplatin entirely in patients with pre-existing sensorineural hearing loss. Instead, I opt for carboplatin-based regimens. If alternative agents are not acceptable (young patient, willing to risk hearing loss for minimal improvement in efficacy, etc.), I carefully consider weekly ...

I agree. In patients with neurosensory hearing loss, I try to avoid the use of cisplatin and will treat with a carboplatin-based regimen (i.e., carboplatin and paclitaxel) or with single-agent carboplatin every 3 weeks. If cisplatin is the only option, then I agree that weekly cisplatin should be ad...