Raaijmakers Esther, Engelen Antoine M
Department of Radiotherapy, Dr Bernard Verbeeten Institute, Tilburg, The Netherlands.
Radiother Oncol. 2002 Oct;65(1):1-7. doi: 10.1016/s0167-8140(02)00211-6.
Little has been published about permanent hearing loss due to radiotherapy, thus making it a rather unknown phenomenon. Therefore, we performed a study of the literature over the last 20 years.
Sixteen relevant clinical studies were found, reporting mostly on nasopharyngeal or parotid gland treatments. Hearing loss was measured using a pure tone audiogram. Studies were assessed using a simple scoring list. Nine studies were used for further analysis. Data on the pure tone audiogram were pooled.
Results showed that, especially in the higher frequencies (> or =4 kHz), loss can be measured. When data were pooled, in 42 +/- 3% of the patients a hearing loss was found of 10 dB or more at 4 kHz. Averaged over all measured frequencies the effect is less prominent but still statistically significant (18 +/- 2%). No significant difference between nasopharyngeal and parotid gland treatment was found (P < 0.05).
Only a few studies, mostly concerning small patient numbers, have investigated hearing damage due to radiotherapy. So far there has been no consensus on the subject. However, in this systematic review we found a significant effect. Dose to the inner ear therefore deserves more attention, especially in dose escalation studies and inverse planning.
关于放疗导致永久性听力损失的报道较少，因此这是一种相对鲜为人知的现象。为此，我们对过去20年的文献进行了一项研究。
共找到16项相关临床研究，大多报道了鼻咽癌或腮腺治疗。使用纯音听力图测量听力损失。采用简单评分表对研究进行评估。9项研究用于进一步分析。汇总纯音听力图的数据。
结果显示，尤其是在较高频率（≥4kHz）时，可以测量到听力损失。汇总数据后，42±3%的患者在4kHz时听力损失达10dB或更高。在所有测量频率上平均，这种影响不太显著，但仍具有统计学意义（18±2%）。未发现鼻咽癌和腮腺治疗之间存在显著差异（P<0.05）。
仅有少数研究（大多涉及患者数量较少）调查了放疗导致的听力损伤。到目前为止，关于该主题尚未达成共识。然而，在本系统评价中我们发现了显著影响。因此，内耳剂量值得更多关注，尤其是在剂量递增研究和逆向计划中。
