{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:02:09Z","timestamp":1790078529536,"version":"4.0.1"},"reference-count":31,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Romania","id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background and Objectives: Audiometric monitoring is recommended for patients receiving ototoxic (chemo)radiotherapy for head and neck cancer (HNC), yet real-world uptake is poorly characterized and potentially inequitable. We quantified the uptake and timing of audiometric testing and examined rural\u2013urban residence and age as candidate determinants. Materials and Methods: We conducted a single-center retrospective cohort study of 70 consecutive patients with HNC treated with radiotherapy between November 2024 and September 2025, comparing rural (n = 32) and urban (n = 38) residents. Outcomes were audiometric testing at treatment initiation, repeat audiometry during follow-up, and post-treatment hearing change. Analyses included Fisher\u2019s exact and Mann\u2013Whitney U tests, Spearman correlations, Firth-penalized logistic regression, inverse probability of treatment weighting (IPTW), restricted cubic splines, and sensitivity analyses. Results: Audiometry at treatment initiation was performed in 31\/70 patients (44.3%) and repeat audiometry in only 10\/70 (14.3%); among tested patients with documented dates, just 19.4% underwent audiometry before the first radiotherapy fraction, so that a true pre-exposure baseline existed for only 6\/70 patients (8.6%). Uptake at initiation was 53.7% with concurrent cisplatin, 14.3% with carboplatin, and 36.4% with radiotherapy alone (p = 0.114). Uptake did not differ by residence (rural 40.6% vs. urban 47.4%; odds ratio (OR) 0.76, 95% confidence interval (CI) 0.30\u20131.96, p = 0.634), with an IPTW-weighted risk difference of \u22129.9% (95% CI \u221230.9 to +11.8). Age was the dominant determinant: uptake fell from 90.5% below 65 years to 24.5% at \u226565 years (adjusted OR per decade 0.32, 95% CI 0.15\u20130.71, p = 0.005), with significant non-linearity (p = 0.015). Pre-existing hearing loss was associated with lower testing (OR 0.29, 95% CI 0.10\u20130.91, p = 0.032). Post-treatment hearing change occurred in 54.3% overall (rural 46.9% vs. urban 60.5%, p = 0.336), comprising a subjective hearing complaint in 51.4% and audiometric deterioration in six of the nine patients with paired audiograms. Conclusions: Audiometric monitoring was incomplete, rarely obtained before irradiation, and steeply age-patterned, whereas rural residence was not associated with lower uptake; structured, exposure-based referral pathways, triggered by planned cisplatin and clinically relevant cochlear dose and applied irrespective of age, are warranted.<\/jats:p>","DOI":"10.3390\/medsci14050593","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:21:48Z","timestamp":1790072508000},"page":"593","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Audiometric Monitoring and Its Determinants in Patients Undergoing Chemoradiotherapy for Head and Neck Cancer"],"prefix":"10.3390","volume":"14","author":[{"given":"Anda-Ioana","family":"Morgovan","sequence":"first","affiliation":[{"name":"Department of ENT, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7755-4608","authenticated-orcid":false,"given":"Nicolae Constantin","family":"Balica","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3002-7656","authenticated-orcid":false,"given":"Cristina Mihaela","family":"Negru","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"given":"Kristine","family":"Guran","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"given":"Alexandru","family":"Orasan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Mihaela Andreea","family":"Banta","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5243-0259","authenticated-orcid":false,"given":"Crina Oana","family":"Pintea","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Mihaela Iuliana","family":"Ciortan (Sirbu)","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6669-7715","authenticated-orcid":false,"given":"Horatiu Eugen","family":"Stefanescu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, 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