Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan.
Otolaryngol Head Neck Surg. 2010 Nov;143(5):662-8. doi: 10.1016/j.otohns.2010.07.012.
To investigate the otologic complications in patients with nasopharyngeal carcinoma (NPC) who were treated by intensity-modulated radiotherapy (IMRT) and compared with those who were treated by two-dimensional radiotherapy (2DRT).
A historical cohort study was performed comprising NPC patients who underwent IMRT or 2DRT at Chung Shan Medical University Hospital.
Chung Shan Medical University Hospital.
Twenty-six NPC patients treated by IMRT (group A) and 18 NPC patients treated by 2DRT (group B) were enrolled. All patients underwent otoscopy, audiometry, and a vestibular-evoked myogenic potential (VEMP) test at a mean interval of three years after irradiation.
Although groups A and B did not significantly differ in the occurrence rate of otitis media with effusion (OME), group B had a significantly greater occurrence rate of chronic otitis media than group A (P < 0.05, χ(2) test). The incidences of high-frequency sensorineural hearing loss were 46 percent in group A and 67 percent in group B, with no significant difference between the two. In terms of VEMPs, group A had a significantly lower abnormal rate (31%) than group B (61%; P < 0.05, χ(2) test). In addition, a significant relationship existed between T stages and OME in NPC patients treated by IMRT (P < 0.01, Fisher-Freeman-Halton test) but not by 2DRT.
The incidence of chronic otitis media and abnormal VEMPs in NPC patients treated by IMRT were significantly lower when compared with those treated by 2DRT, demonstrating the superiority of IMRT in decreasing unwanted otologic complications. However, occurrence of OME, which was related with advanced T stage, cannot be reduced by IMRT.
研究调强放疗（IMRT）与二维放疗（2DRT）治疗鼻咽癌（NPC）患者的耳科学并发症，并进行比较。
这是一项回顾性队列研究，纳入了在中山医学大学附属医院接受 IMRT 或 2DRT 治疗的 NPC 患者。
中山医学大学附属医院。
共纳入 26 例接受 IMRT（A 组）和 18 例接受 2DRT（B 组）的 NPC 患者。所有患者在放疗后平均 3 年进行耳镜检查、听力测试和前庭诱发肌源性电位（VEMP）检查。
尽管 A 组和 B 组分泌性中耳炎（OME）的发生率无显著差异，但 B 组慢性中耳炎的发生率明显高于 A 组（P<0.05，卡方检验）。A 组高频感音神经性听力损失的发生率为 46%，B 组为 67%，两组之间无显著差异。在 VEMPs 方面，A 组的异常率（31%）明显低于 B 组（61%；P<0.05，卡方检验）。此外，在接受 IMRT 治疗的 NPC 患者中，T 分期与 OME 之间存在显著关系（P<0.01，Fisher-Freeman-Halton 检验），但在接受 2DRT 治疗的患者中则无此关系。
与 2DRT 相比，接受 IMRT 治疗的 NPC 患者慢性中耳炎和异常 VEMPs 的发生率明显降低，表明 IMRT 在减少不必要的耳科学并发症方面具有优势。然而，与晚期 T 分期相关的 OME 仍不能通过 IMRT 来降低。
