Concurrent use of sodium thiosulfate (STS) with platinum-based chemotherapy appears to decrease the risk of ototoxic effects without affecting survival, according to research published in JAMA Network Open.

The researchers noted that STS has emerged as a promising otoprotectant in patients receiving platinum-based chemotherapy, but it isn’t clear if STS compromises the efficacy of the chemotherapy.

To gain some insight, the researchers conducted a meta-analysis of 4 studies — 3 randomized trials and 1 controlled study. The studies included a total of 278 cancer patients receiving platinum-based chemotherapy, with or without STS.

Results showed that STS significantly decreased the risk of developing ototoxic effects (relative risk [RR], 0.61; 95% CI, 0.49-0.77; P <.001). However, the route of administration appeared to affect results.

For the 3 studies in which STS was administered intravenously, STS was associated with a decreased risk of ototoxic effects compared with no STS (RR, 0.57; 95% CI, 0.45-0.73; P <.001).

In the remaining study, STS was administered into the middle ear, and there was a nonsignificant difference in ototoxic effects between the STS and no-STS groups (RR, 0.89; 95% CI, 0.51-1.56; P =.68).

Two of the studies included survival analyses and showed no significant differences in survival between patients who received STS and those who did not. This was true for event-free survival (P =.61) and overall survival (P =.09).

However, the researchers concluded that “whether [STS] is associated with an increased risk of poor event-free survival and overall survival requires further large-scale studies.”


Chen C-H, Huang C-Y, Haley Lin H-Y, Wang M-C, Chang C-Y, Cheng Y-F. Association of sodium thiosulfate with risk of ototoxic effects from platinum-based chemotherapy: A systematic review and meta-analysis. JAMA Netw Open. 2021;4(8):e2118895. doi:10.1001/jamanetworkopen.2021.18895