Honoré Henriette B, Bentzen Søren M, Møller Kitty, Grau Cai
Department of Medical Physics, Aarhus University Hospital, Nørrebrogade 44, Building 5, DK-8000 Aarhus C, Denmark.
Radiother Oncol. 2002 Oct;65(1):9-16. doi: 10.1016/s0167-8140(02)00173-1.
Sensori-neural hearing loss (SNHL) is a common complication to radiation therapy in the upper head and neck region. In this study, we estimated the dose response relationship for SNHL with adjustment for pre-therapeutic risk factors.
The pre- and post-therapeutic hearing levels were recorded in a previously published study of 20 patients receiving radiotherapy for nasopharyngeal carcinoma. In the present study, the dose to the inner ear of these patients was estimated with a computed tomography (CT) based treatment planning system. CT data from a 'proxy patient' were used for patients with no available CT scan. SNHL was analyzed as a function of radiation dose and potential risk factors were tested.
The incidence of SNHL increased significantly with increasing dose to the cochlea. Increasing patient's age, and decreasing pre-therapeutic hearing level were statistically significantly associated with an increased risk of SNHL. A nomogram is presented for estimating individualized dose constraints of potential use in treatment planning.
The inner ear is a critical structure in patients with nasopharyngeal carcinoma and the dose to the inner ear should be carefully considered when planning radiation treatment in this region.
感音神经性听力损失（SNHL）是头颈部上段放疗常见的并发症。在本研究中，我们在对治疗前危险因素进行校正的情况下估计了SNHL的剂量反应关系。
在一项先前发表的对20例接受鼻咽癌放疗患者的研究中记录了治疗前后的听力水平。在本研究中，使用基于计算机断层扫描（CT）的治疗计划系统估计这些患者内耳的剂量。对于没有可用CT扫描的患者，使用来自“替代患者”的CT数据。分析SNHL作为辐射剂量的函数，并对潜在危险因素进行检测。
SNHL的发生率随耳蜗剂量增加而显著增加。患者年龄增加以及治疗前听力水平降低与SNHL风险增加在统计学上显著相关。给出了一个列线图，用于估计在治疗计划中可能使用的个体化剂量限制。
内耳是鼻咽癌患者的关键结构，在该区域进行放射治疗计划时应仔细考虑内耳的剂量。
