Cisplatin carries a well-known risk of ototoxicity, which is commonly monitored with baseline audiometry.

• A. Cisplatin is a known cause of ototoxicity requiring baseline audiogram.
• B. Methotrexate is primarily associated with ototoxicity.
• C. Doxorubicin has the highest risk of ototoxicity.
• D. Etoposide is the primary cause of ototoxicity.

Answer: (A)

Ototoxicity is a drug-induced injury to the inner ear, and cisplatin is a well-known culprit that can cause dose-related hearing loss, often starting in the higher frequencies and potentially progressing as treatment continues. Because the risk increases with cumulative exposure, it's essential to establish a baseline hearing status before starting therapy. Baseline audiometry provides a reference point so any subsequent changes can be detected early and used to guide treatment decisions, such as adjusting the cisplatin dose or altering the schedule to protect remaining hearing. If a decline is detected during therapy, clinicians can respond promptly to mitigate further damage and plan for long-term rehabilitation if needed.

In contrast, the other agents listed have different primary toxicity profiles. Methotrexate is not mainly associated with ototoxicity; doxorubicin is best known for cardiotoxicity; etoposide does not carry a high risk of ototoxicity. So the statement that cisplatin carries a risk of ototoxicity and requires baseline audiometry best matches the drug’s established toxicity pattern and monitoring practice.