Theunissen Eleonoor A R, Zuur Charlotte L, Bosma Sophie C J, Lopez-Yurda Marta, Hauptmann Michael, van der Baan Sieberen, de Boer Jan Paul, van der Molen Lisette, Rasch Coen R N, Dreschler Wouter A, Balm Alfons J M
Department of Head and Neck Oncology and Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Laryngoscope. 2014 Dec;124(12):2720-5. doi: 10.1002/lary.24802. Epub 2014 Jun 26.
OBJECTIVES/HYPOTHESIS: The purpose of this study was to determine whether concomitant chemoradiation (CCRT)-induced hearing loss is progressive over time or not.
Long-term (LT) follow-up study.
Between 1999 and 2004, 158 patients with head and neck cancer were treated with intravenous (IV) CCRT (n = 80) or intraarterial CCRT (n = 78). Audiometry was performed before, short-term (ST), and LT posttreatment. Differences in hearing were assessed with a multivariable linear regression analysis, incorporating the effect of aging.
Long-term audiometry (median 4.5 years) was available in 67 patients (42%). At ST follow-up, a deterioration of 21.6 decibel was seen compared to baseline at pure-tone averages (PTA) 8-10-12.5 kHz. At LT follow-up, this deterioration further increased with 5 decibel (P = 0.005). Only in CCRT-IV patients was a significant progressive treatment-induced hearing loss seen, at PTA 8-10-12.5 kHz (P = 0.005), PTA 1-2-4 kHz air conduction (P = 0.014), and PTA 0.5-1-2 kHz bone conduction (P = 0.045).
CCRT-induced hearing impairment was progressive over time, especially in higher frequencies and only in CCRT-IV patients, with a modest deterioration of 5 decibel 4.5 years post-treatment.
目的/假设：本研究的目的是确定同步放化疗（CCRT）引起的听力损失是否会随时间进展。
长期随访研究。
1999年至2004年间，158例头颈癌患者接受了静脉（IV）CCRT（n = 80）或动脉内CCRT（n = 78）治疗。在治疗前、短期（ST）和长期（LT）治疗后进行听力测定。采用多变量线性回归分析评估听力差异，并纳入衰老的影响。
67例患者（42%）有长期听力测定数据（中位时间4.5年）。在ST随访时，与基线相比，8-10-12.5kHz纯音平均听阈（PTA）下降了21.6分贝。在LT随访时，这种下降进一步增加了5分贝（P = 0.005）。仅在CCRT-IV患者中，在8-10-12.5kHz PTA（P = 0.005）、1-2-4kHz气导PTA（P = 0.014）和0.5-1-2kHz骨导PTA（P = 0.045）时观察到显著的治疗性渐进性听力损失。
CCRT引起的听力损害随时间进展，尤其是在高频，且仅在CCRT-IV患者中出现，治疗后4.5年有适度的5分贝下降。
4级。
