PURPOSE: Radiotherapy (RT) is a common treatment of head-and-neck carcinoma. The objective of this study was to perform a prospective multivariate assessment of the dose-effect relationship between intensity-modulated RT and hearing loss. METHODS AND MATERIALS: Pure tone audiometry at 0.250-16 kHz was obtained before and after treatment in 101 patients (202 ears). All patients received full-course intensity-modulated RT (range, 56-70 Gy), with a median cochlear dose of 11.4 Gy (range, 0.2-69.7). RESULTS: Audiometry was performed 1 week before and a median of 9 weeks (range, 1-112) after treatment. The mean hearing deterioration at pure tone average air-conduction 1-2-4 kHz was small (from 28.6 dB HL to 30.1 dB HL). However, individual patients showed clinically significant hearing loss, with 10-dB threshold shift incidences of 13% and 18% at pure tone averages air-conduction 1-2-4 kHz and 8-10-12.5 kHz, respectively. Post-treatment hearing capability was unfavorable in the case of greater inner ear radiation doses (p <0.0001), unfavorable baseline hearing capability (p <0.0001), green-eyed patients (p <0.0001), and older age (p <0.0001). Using multivariate analysis, a prediction of individual hearing capabiltity after treatment was made. CONCLUSION: RT-induced hearing loss in the mean population is modest. However, clinically significant hearing loss was observed in older patients with green eyes and unfavorable pretreatment hearing. In these patients, the intended radiation dose may be adjusted according to the proposed predictive model, aiming to decrease the risk of ototoxicity.
PURPOSE: Radiotherapy (RT) is a common treatment of head-and-neck carcinoma. The objective of this study was to perform a prospective multivariate assessment of the dose-effect relationship between intensity-modulated RT and hearing loss. METHODS AND MATERIALS: Pure tone audiometry at 0.250-16 kHz was obtained before and after treatment in 101 patients (202 ears). All patients received full-course intensity-modulated RT (range, 56-70 Gy), with a median cochlear dose of 11.4 Gy (range, 0.2-69.7). RESULTS: Audiometry was performed 1 week before and a median of 9 weeks (range, 1-112) after treatment. The mean hearing deterioration at pure tone average air-conduction 1-2-4 kHz was small (from 28.6 dB HL to 30.1 dB HL). However, individual patients showed clinically significant hearing loss, with 10-dB threshold shift incidences of 13% and 18% at pure tone averages air-conduction 1-2-4 kHz and 8-10-12.5 kHz, respectively. Post-treatment hearing capability was unfavorable in the case of greater inner ear radiation doses (p <0.0001), unfavorable baseline hearing capability (p <0.0001), green-eyed patients (p <0.0001), and older age (p <0.0001). Using multivariate analysis, a prediction of individual hearing capabiltity after treatment was made. CONCLUSION: RT-induced hearing loss in the mean population is modest. However, clinically significant hearing loss was observed in older patients with green eyes and unfavorable pretreatment hearing. In these patients, the intended radiation dose may be adjusted according to the proposed predictive model, aiming to decrease the risk of ototoxicity.
Authors: Dawn Konrad-Martin; Gayla L Poling; Angela C Garinis; Candice E Ortiz; Jennifer Hopper; Keri O'Connell Bennett; Marilyn F Dille Journal: Int J Audiol Date: 2017-11-20 Impact factor: 2.117
Authors: Neerav Goyal; Andrew Day; Joel Epstein; Joseph Goodman; Evan Graboyes; Scharukh Jalisi; Ana P Kiess; Jamie A Ku; Matthew C Miller; Aru Panwar; Vijay A Patel; Assuntina Sacco; Vlad Sandulache; Amy M Williams; Daniel Deschler; D Gregory Farwell; Cherie-Ann Nathan; Carole Fakhry; Nishant Agrawal Journal: Laryngoscope Investig Otolaryngol Date: 2021-11-30
Authors: Eleonoor A R Theunissen; Charlotte L Zuur; Marta Lopez Yurda; Sieberen van der Baan; Anne F Kornman; Jan Paul de Boer; Alfons J M Balm; Coen R N Rasch; Wouter A Dreschler Journal: J Otolaryngol Head Neck Surg Date: 2014-08-06
Authors: Christopher M Nutting; James P Morden; Matthew Beasley; Shreerang Bhide; Audrey Cook; Emma De Winton; Marie Emson; Mererid Evans; Lydia Fresco; Simon Gollins; Dorothy Gujral; Kevin Harrington; Mano Joseph; Catherine Lemon; Linda Luxon; Qurrat van den Blink; Ruheena Mendes; Aisha Miah; Kate Newbold; Robin Prestwich; Martin Robinson; Paul Sanghera; Joanna Simpson; Muthiah Sivaramalingam; Narayanan Nair Srihari; Mark Sydenham; Emma Wells; Stephanie Witts; Emma Hall Journal: Eur J Cancer Date: 2018-10-01 Impact factor: 9.162