Zuur Charlotte L, Simis Yvonne J W, Verkaik Roxanna S, Schornagel Jan H, Balm Alfons J M, Dreschler Wouter A, Rasch Coen R N
Department of Head and Neck Surgery, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
Radiother Oncol. 2008 Oct;89(1):38-43. doi: 10.1016/j.radonc.2008.06.003. Epub 2008 Aug 14.
Cisplatin-based chemo-irradiation (CRT) is increasingly used for head and neck squamous cell carcinoma (HNSCC). We aimed to assess hearing deterioration due to low-dose cisplatin chemoradiation and to compare the observed hearing loss with hearing loss in our previously described high-dose cisplatin CRT cohort.
A prospective analysis of hearing thresholds at low and (ultra)-high frequencies obtained before and after treatment in 60 patients. Patients received low-dose cisplatin (6mg/m(2), daily infusions, 20-25 days) with concomitant accelerated radiotherapy (70Gy).
Audiometry up to 16kHz was performed before therapy and 31 days (median) post-treatment. The total incidence of ototoxicity in CTCAEv3.0 was 31% in audiograms up to 8kHz, and 5% of ears tested qualified for HAs due to treatment. The mean hearing loss at speech frequencies was 2.6dB (SD 5.7) and 2.3dB (SD 9.2) at PTA 1-2-4kHz air-conduction and bone-conduction, respectively. The mean hearing loss at ultra-high frequencies (PTA AC 8-10-12.5kHz) was 9.0dB (SD 8.1). Low-dose cisplatin CRT caused less acute hearing loss (CTCAE 31%), compared to high-dose cisplatin CRT (CTCAE 78%).
Low-dose cisplatin chemo-irradiation for HNSCC is a relatively safe treatment protocol with respect to ototoxicity.
基于顺铂的放化疗（CRT）越来越多地用于头颈部鳞状细胞癌（HNSCC）。我们旨在评估低剂量顺铂放化疗导致的听力减退，并将观察到的听力损失与我们之前描述的高剂量顺铂CRT队列中的听力损失进行比较。
对60例患者治疗前后获得的低频和（超）高频听力阈值进行前瞻性分析。患者接受低剂量顺铂（6mg/m²，每日输注，20 - 25天）并同时进行加速放疗（70Gy）。
在治疗前和治疗后31天（中位数）进行了高达16kHz的听力测定。在高达8kHz的听力图中，CTCAEv3.0中耳毒性的总发生率为31%，因治疗而测试合格的耳朵中有5%需要佩戴助听器。在PTA 1 - 2 - 4kHz气导和骨导时，言语频率的平均听力损失分别为2.6dB（标准差5.7）和2.3dB（标准差9.2）。超高频（PTA AC 8 - 10 - 12.5kHz）的平均听力损失为9.0dB（标准差8.1）。与高剂量顺铂CRT（CTCAE 78%）相比，低剂量顺铂CRT导致的急性听力损失较少（CTCAE 31%）。
就耳毒性而言，低剂量顺铂放化疗治疗HNSCC是一种相对安全的治疗方案。
