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- Publisher Website: 10.1016/j.ijrobp.2008.07.034
- Scopus: eid_2-s2.0-62649131170
- PMID: 18922648
- WOS: WOS:000264728000007
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Article: Sensorineural Hearing Loss After Treatment of Nasopharyngeal Carcinoma: A Longitudinal Analysis
Title | Sensorineural Hearing Loss After Treatment of Nasopharyngeal Carcinoma: A Longitudinal Analysis |
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Authors | |
Keywords | Prognostic factors Sensorineural hearing loss Chemoradiotherapy Dose constraint Nasopharyngeal carcinoma |
Issue Date | 2009 |
Citation | International Journal of Radiation Oncology - Biology - Physics, 2009, v. 73, n. 5, p. 1335-1342 How to Cite? |
Abstract | Purpose: To analyze the effects of radiotherapy (RT) and chemotherapy in relation to sensorineural hearing loss (SNHL) after contemporary treatment of nasopharyngeal carcinoma. Methods and Materials: A total of 87 nasopharyngeal carcinoma patients were treated with RT or chemoradiotherapy using either three-dimensional conformal RT or intensity-modulated RT between 2004 and 2005. Tympanometry and pure-tone audiogram assessments were performed before treatment and then serially at 6-month intervals. The dose-volume data of the cochlea were analyzed. The effects of cisplatin administered in concurrent and nonconcurrent phases was explored. Results: Of the 170 eligible ears, RT (n = 30) and chemoradiotherapy (n = 140) resulted in 40% (n = 12) and 56.4% (n = 79) persistent SNHL (≥15 dB loss), respectively, after a median follow-up of 2 years. SNHL at a high frequency was more frequent statistically in the chemoradiotherapy group than in the RT-alone group (55% vs. 33.3%, p < 0.01), but not at a low frequency (7.9% vs. 16.7%, p = 0.14). Within the chemoradiotherapy group, the mean cochlea dose and concurrent cisplatin dose were important determinants of high-frequency SNHL, with an odds ratio of 1.07/Gy increase (p = 0.01) and an odds ratio of 1.008/mg/m2 increase (p < 0.01), respectively. Age, gender, and nonconcurrent cisplatin dose were not statistically significant factors. A mean radiation dose to the cochlea of <47 Gy would result in <15% of patients developing severe (≥30 dB) high-frequency SNHL. Conclusion: The results of our study have shown that high-frequency SNHL is significantly related to the mean cochlea dose and the concurrent cisplatin dose. A mean dose constraint of 47 Gy to the cochlea is recommended to minimize SNHL after chemoradiotherapy. © 2009 Elsevier Inc. All rights reserved. |
Persistent Identifier | http://hdl.handle.net/10722/213921 |
ISSN | 2023 Impact Factor: 6.4 2023 SCImago Journal Rankings: 1.992 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chan, S. H. | - |
dc.contributor.author | Ng, W. T. | - |
dc.contributor.author | Kam, K. L. | - |
dc.contributor.author | Lee, Michael C H | - |
dc.contributor.author | Choi, C. W. | - |
dc.contributor.author | Yau, T. K. | - |
dc.contributor.author | Lee, Anne W M | - |
dc.contributor.author | Chow, S. K. | - |
dc.date.accessioned | 2015-08-19T13:41:14Z | - |
dc.date.available | 2015-08-19T13:41:14Z | - |
dc.date.issued | 2009 | - |
dc.identifier.citation | International Journal of Radiation Oncology - Biology - Physics, 2009, v. 73, n. 5, p. 1335-1342 | - |
dc.identifier.issn | 0360-3016 | - |
dc.identifier.uri | http://hdl.handle.net/10722/213921 | - |
dc.description.abstract | Purpose: To analyze the effects of radiotherapy (RT) and chemotherapy in relation to sensorineural hearing loss (SNHL) after contemporary treatment of nasopharyngeal carcinoma. Methods and Materials: A total of 87 nasopharyngeal carcinoma patients were treated with RT or chemoradiotherapy using either three-dimensional conformal RT or intensity-modulated RT between 2004 and 2005. Tympanometry and pure-tone audiogram assessments were performed before treatment and then serially at 6-month intervals. The dose-volume data of the cochlea were analyzed. The effects of cisplatin administered in concurrent and nonconcurrent phases was explored. Results: Of the 170 eligible ears, RT (n = 30) and chemoradiotherapy (n = 140) resulted in 40% (n = 12) and 56.4% (n = 79) persistent SNHL (≥15 dB loss), respectively, after a median follow-up of 2 years. SNHL at a high frequency was more frequent statistically in the chemoradiotherapy group than in the RT-alone group (55% vs. 33.3%, p < 0.01), but not at a low frequency (7.9% vs. 16.7%, p = 0.14). Within the chemoradiotherapy group, the mean cochlea dose and concurrent cisplatin dose were important determinants of high-frequency SNHL, with an odds ratio of 1.07/Gy increase (p = 0.01) and an odds ratio of 1.008/mg/m2 increase (p < 0.01), respectively. Age, gender, and nonconcurrent cisplatin dose were not statistically significant factors. A mean radiation dose to the cochlea of <47 Gy would result in <15% of patients developing severe (≥30 dB) high-frequency SNHL. Conclusion: The results of our study have shown that high-frequency SNHL is significantly related to the mean cochlea dose and the concurrent cisplatin dose. A mean dose constraint of 47 Gy to the cochlea is recommended to minimize SNHL after chemoradiotherapy. © 2009 Elsevier Inc. All rights reserved. | - |
dc.language | eng | - |
dc.relation.ispartof | International Journal of Radiation Oncology - Biology - Physics | - |
dc.subject | Prognostic factors | - |
dc.subject | Sensorineural hearing loss | - |
dc.subject | Chemoradiotherapy | - |
dc.subject | Dose constraint | - |
dc.subject | Nasopharyngeal carcinoma | - |
dc.title | Sensorineural Hearing Loss After Treatment of Nasopharyngeal Carcinoma: A Longitudinal Analysis | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/j.ijrobp.2008.07.034 | - |
dc.identifier.pmid | 18922648 | - |
dc.identifier.scopus | eid_2-s2.0-62649131170 | - |
dc.identifier.hkuros | 266189 | - |
dc.identifier.volume | 73 | - |
dc.identifier.issue | 5 | - |
dc.identifier.spage | 1335 | - |
dc.identifier.epage | 1342 | - |
dc.identifier.isi | WOS:000264728000007 | - |
dc.identifier.issnl | 0360-3016 | - |