头颈部癌患者的听力评估：接受顺铂治疗患者中不良事件通用术语标准、布罗克（Brock）和张（Chang）不良事件标准的比较
Hearing evaluation of patients with head and neck cancer: Comparison of Common Terminology Criteria for Adverse Events, Brock and Chang adverse event criteria in patients receiving cisplatin.
作者信息
Colevas A Dimitrios, Lira Ruth R, Colevas Electra A, Lavori Philip W, Chan Cato, Shultz David B, Chang Kay W
机构信息
Department of Medicine (Oncology), Stanford Cancer Institute, Stanford University, Stanford, California.
Department of Health Research and Policy - Biostatistics, Stanford University, Stanford, California.
出版信息
Head Neck. 2015 Aug;37(8):1102-7. doi: 10.1002/hed.23714. Epub 2014 Jul 11.
BACKGROUND
The purpose of this study was to compare Common Terminology Criteria for Adverse Events (CTCAE), Brock and Chang hearing loss grading in patients with head and neck cancer receiving cis-diamminedichloroplatinum (CDDP). Endpoints were baseline distribution of hearing loss, interobserver consistency, and sensitivity to hearing loss after CDDP treatment.
METHODS
Four hundred sixty single ear audiograms in 110 patients with head and neck cancer were graded. Hearing loss at baseline, interobserver agreement rates, and changes in hearing loss after CDDP were evaluated.
RESULTS
The Chang and Brock tools' baseline hearing loss distribution was concentrated at grade 0 (57% and 41%, respectively), whereas 47%, per the CTCAE, had grade 3 baseline hearing loss. Interobserver agreement was highest for the Brock scale (≥90%) followed by the Chang (≥89%) and CTCAE (≥75%) scales. Detection of change after CDDP was highest for Chang (48%) followed by Brock (45%) and the CTCAE (32%).
CONCLUSION
The Brock and Chang tools may be superior to the CTCAE in patients with head and neck cancer receiving CDDP using baseline hearing loss distribution, interobserver agreement, and detection of hearing loss grade change as performance indicators.
背景
本研究的目的是比较接受顺二氯二氨铂（CDDP）治疗的头颈癌患者的不良事件通用术语标准（CTCAE）、布罗克（Brock）和张（Chang）听力损失分级。观察指标为听力损失的基线分布、观察者间一致性以及CDDP治疗后对听力损失的敏感性。
方法
对110名头颈癌患者的460次单耳听力图进行分级。评估基线时的听力损失、观察者间的一致率以及CDDP治疗后听力损失的变化。
结果
张和布罗克工具的基线听力损失分布集中在0级（分别为57%和41%），而根据CTCAE，47%的患者基线听力损失为3级。观察者间一致性在布罗克量表中最高（≥90%），其次是张量表（≥89%）和CTCAE量表（≥75%）。CDDP治疗后变化的检测率在张量表中最高（48%），其次是布罗克量表（45%）和CTCAE量表（32%）。
结论
以基线听力损失分布、观察者间一致性以及听力损失分级变化的检测作为性能指标，在接受CDDP治疗的头颈癌患者中，布罗克和张工具可能优于CTCAE。
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