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• W2048585220 abstract "Purpose/Objective(s)The incidence of sensorineural hearing loss (SNHL) after treatment with combined IMRT and cisplatin based chemotherapy in nasopharyngeal carcinoma (NPC) patients was evaluated, and relationships of SNHL with radiation dosimetric parameters and other patient and treatment-related factors were investigated.Materials/MethodsFifty-three NPC patients treated with curative IMRT from 2004 to 2009 were analyzed. Of these patients, 51 received neo-adjuvant, concurrent, or adjuvant use of cisplatin. Pure tone audiometry was performed in the follow-up with median follow-up time of 60 months, ranging 28 - 84 months. Correlation of SNHL at low frequencies (pure tone average, 0.5 - 2 kHz) with a series of radiation dosimetric parameters for inner ear, cochlea, and internal auditory canal (IAC) and other factors was analyzed.ResultsAmong 106 eligible ears, 15 (14.2%) had low frequencies SNHL and 47 (44.3%) high frequency (4 kHz) SNHL. The incidence of low frequencies SNHL was greater in patients with age > 40, T-stage 4, or those who received cumulative cisplatin dose > 200mg/m2 (P = 0.031, 0.044, and 0.031, respectively), and in ears with secretory otitis media (SOM) (P = 0.015). The minimum radiation dose to 0.1 cc highest dose volume (D0.1cc), median dose, V50, D0.035cc, the equivalent uniform dose (EUD) and maximum dose for cochlea were associated with SNHL(P = 0.028, 0.037, 0.044, 0.044, 0.044 and 0.055, respectively). Univariate logistic regression show that the EUD of cochlea was mostly significant for determining SNHL when the EUD was calculated with parameters a = 100 (P = 0.044). The calculated EUD values mostly correlated with the maximum dose and D0.035cc (r2 = 0.999 and 0.984, respectively, with all P-values < 0.001), indicating that cochlea is a serial-type organ. Multivariate analysis indicated that age, cumulative cisplatin dose, SOM, and D0.1cc (P = 0.024, 0.028, 0.063, and 0.057, respectively) were the factors associated with SNHL. Similar dosimetric correlation was for inner ear but not for IAC.ConclusionsIn our datasets, the incidence of treatment-related SNHL depends on age, cumulative cisplatin dose, radiation D0.1cc of cochlea, and SOM. In addition, various radiation dosimetric parameters that describe high dose portions of the dose distribution for cochlea were found to correlate with SNHL. The EUD for cochlea is dominated by the maximum dose, implying that cochlea might be a serially organized organ. The study provides new information on treatment-related SNHL, particularly the new relationships between radiation parameters and SNHL, that will be useful to design radiation treatments leading to improved treatment outcome for nasopharyngeal carcinoma and other head and neck and brain cancers. Purpose/Objective(s)The incidence of sensorineural hearing loss (SNHL) after treatment with combined IMRT and cisplatin based chemotherapy in nasopharyngeal carcinoma (NPC) patients was evaluated, and relationships of SNHL with radiation dosimetric parameters and other patient and treatment-related factors were investigated. The incidence of sensorineural hearing loss (SNHL) after treatment with combined IMRT and cisplatin based chemotherapy in nasopharyngeal carcinoma (NPC) patients was evaluated, and relationships of SNHL with radiation dosimetric parameters and other patient and treatment-related factors were investigated. Materials/MethodsFifty-three NPC patients treated with curative IMRT from 2004 to 2009 were analyzed. Of these patients, 51 received neo-adjuvant, concurrent, or adjuvant use of cisplatin. Pure tone audiometry was performed in the follow-up with median follow-up time of 60 months, ranging 28 - 84 months. Correlation of SNHL at low frequencies (pure tone average, 0.5 - 2 kHz) with a series of radiation dosimetric parameters for inner ear, cochlea, and internal auditory canal (IAC) and other factors was analyzed. Fifty-three NPC patients treated with curative IMRT from 2004 to 2009 were analyzed. Of these patients, 51 received neo-adjuvant, concurrent, or adjuvant use of cisplatin. Pure tone audiometry was performed in the follow-up with median follow-up time of 60 months, ranging 28 - 84 months. Correlation of SNHL at low frequencies (pure tone average, 0.5 - 2 kHz) with a series of radiation dosimetric parameters for inner ear, cochlea, and internal auditory canal (IAC) and other factors was analyzed. ResultsAmong 106 eligible ears, 15 (14.2%) had low frequencies SNHL and 47 (44.3%) high frequency (4 kHz) SNHL. The incidence of low frequencies SNHL was greater in patients with age > 40, T-stage 4, or those who received cumulative cisplatin dose > 200mg/m2 (P = 0.031, 0.044, and 0.031, respectively), and in ears with secretory otitis media (SOM) (P = 0.015). The minimum radiation dose to 0.1 cc highest dose volume (D0.1cc), median dose, V50, D0.035cc, the equivalent uniform dose (EUD) and maximum dose for cochlea were associated with SNHL(P = 0.028, 0.037, 0.044, 0.044, 0.044 and 0.055, respectively). Univariate logistic regression show that the EUD of cochlea was mostly significant for determining SNHL when the EUD was calculated with parameters a = 100 (P = 0.044). The calculated EUD values mostly correlated with the maximum dose and D0.035cc (r2 = 0.999 and 0.984, respectively, with all P-values < 0.001), indicating that cochlea is a serial-type organ. Multivariate analysis indicated that age, cumulative cisplatin dose, SOM, and D0.1cc (P = 0.024, 0.028, 0.063, and 0.057, respectively) were the factors associated with SNHL. Similar dosimetric correlation was for inner ear but not for IAC. Among 106 eligible ears, 15 (14.2%) had low frequencies SNHL and 47 (44.3%) high frequency (4 kHz) SNHL. The incidence of low frequencies SNHL was greater in patients with age > 40, T-stage 4, or those who received cumulative cisplatin dose > 200mg/m2 (P = 0.031, 0.044, and 0.031, respectively), and in ears with secretory otitis media (SOM) (P = 0.015). The minimum radiation dose to 0.1 cc highest dose volume (D0.1cc), median dose, V50, D0.035cc, the equivalent uniform dose (EUD) and maximum dose for cochlea were associated with SNHL(P = 0.028, 0.037, 0.044, 0.044, 0.044 and 0.055, respectively). Univariate logistic regression show that the EUD of cochlea was mostly significant for determining SNHL when the EUD was calculated with parameters a = 100 (P = 0.044). The calculated EUD values mostly correlated with the maximum dose and D0.035cc (r2 = 0.999 and 0.984, respectively, with all P-values < 0.001), indicating that cochlea is a serial-type organ. Multivariate analysis indicated that age, cumulative cisplatin dose, SOM, and D0.1cc (P = 0.024, 0.028, 0.063, and 0.057, respectively) were the factors associated with SNHL. Similar dosimetric correlation was for inner ear but not for IAC. ConclusionsIn our datasets, the incidence of treatment-related SNHL depends on age, cumulative cisplatin dose, radiation D0.1cc of cochlea, and SOM. In addition, various radiation dosimetric parameters that describe high dose portions of the dose distribution for cochlea were found to correlate with SNHL. The EUD for cochlea is dominated by the maximum dose, implying that cochlea might be a serially organized organ. The study provides new information on treatment-related SNHL, particularly the new relationships between radiation parameters and SNHL, that will be useful to design radiation treatments leading to improved treatment outcome for nasopharyngeal carcinoma and other head and neck and brain cancers. In our datasets, the incidence of treatment-related SNHL depends on age, cumulative cisplatin dose, radiation D0.1cc of cochlea, and SOM. In addition, various radiation dosimetric parameters that describe high dose portions of the dose distribution for cochlea were found to correlate with SNHL. The EUD for cochlea is dominated by the maximum dose, implying that cochlea might be a serially organized organ. The study provides new information on treatment-related SNHL, particularly the new relationships between radiation parameters and SNHL, that will be useful to design radiation treatments leading to improved treatment outcome for nasopharyngeal carcinoma and other head and neck and brain cancers." @default.
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• W2048585220 date "2012-11-01" @default.
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• W2048585220 title "Sensorineural Hearing Loss in Nasopharyngeal Carcinoma Patients Treated With Combined Intensity Modulated Radiation Therapy and Cisplatin-based Chemotherapy" @default.
• W2048585220 doi "https://doi.org/10.1016/j.ijrobp.2012.07.1296" @default.
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