Platinum chemotherapy, radiotherapy and the inner ear: implications for "standard" radiation portals.

In this centre, platinum chemotherapy precedes radiotherapy in several primary malignancies arising in structures adjacent to the mastoid bone. The augmented ototoxicity of platinum and radiotherapy to fields encompassing the inner ear is exemplified by a case report. The order of administration may not be critical. This important toxicity, particularly for young patients, may be reduced by careful shielding considerations during planning of radiation portals, as exemplified in two further cases, and by carboplatin chemotherapy.