Wang Jin, Chen Yuan-Yuan, Tai An, Chen Xue-Lin, Huang Shao-Ming, Yang Cungen, Bao Yong, Li Ning-Wei, Deng Xiao-Wu, Zhao Chong, Chen Ming, Li X Allen
Departments of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, Guangzhou, People's Republic of China; Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI.
Departments of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, Guangzhou, People's Republic of China.
Transl Oncol. 2015 Dec;8(6):456-62. doi: 10.1016/j.tranon.2015.10.003.
The incidence of sensorineural hearing loss (SNHL) after treatment with combination of intensity-modulated radiation therapy (IMRT) and cisplatin-based chemotherapy in nasopharyngeal carcinoma (NPC) patients was evaluated, and relationships of SNHL with host factors, treatment-related factors, and radiation dosimetric parameters were investigated.
Fifty-one NPC patients treated with IMRT from 2004 to 2009 were analyzed. All patients received neoadjuvant, concurrent, or adjuvant use of cisplatin. Pure tone audiometry was performed during the follow-up period with a median time of 60months, ranging from 28 to 84months. Correlation of SNHL at low frequencies (pure tone average, 0.5-2kHz) with a series of factors was analyzed.
Among 102 ears, 12.7% had low-frequency SNHL and 42.2% had high-frequency (4kHz) SNHL. The incidence of low-frequency SNHL was greater in patients with age>40, with T-stage 4, or who received cumulative cisplatin dose (CCD)>200mg/m(2) (P=.034, .011, and .003, respectively) and in ears with secretory otitis media (SOM) (P=.002). Several dosimetric parameters were found to be correlated with SNHL. Univariate analysis showed that the minimum radiation dose to 0.1ml highest dose volume (D0.1ml) of the cochlea was the best radiation-related predictive parameter. Multivariate analysis indicated that CCD, SOM, and D0.1ml of cochlea (P=.035, .012, and .022, respectively) were the factors associated with SNHL.
For NPC patients treated with IMRT and chemotherapy, the incidence of treatment-related SNHL was associated with CCD, D0.1ml of cochlea, and SOM.
评估鼻咽癌（NPC）患者接受调强放射治疗（IMRT）和顺铂类化疗联合治疗后感音神经性听力损失（SNHL）的发生率，并研究SNHL与宿主因素、治疗相关因素及放射剂量学参数之间的关系。
分析2004年至2009年接受IMRT治疗的51例NPC患者。所有患者均接受顺铂的新辅助、同步或辅助使用。在随访期间进行纯音听力测定，中位时间为60个月，范围为28至84个月。分析低频（纯音平均，0.5 - 2kHz）SNHL与一系列因素的相关性。
在102只耳中，12.7%有低频SNHL，42.2%有高频（4kHz）SNHL。年龄>40岁、T分期为4期或接受累积顺铂剂量（CCD）>200mg/m²的患者以及患有分泌性中耳炎（SOM）的耳中低频SNHL的发生率更高（分别为P = 0.034、0.011和0.003）。发现几个剂量学参数与SNHL相关。单因素分析表明，耳蜗0.1ml最高剂量体积的最小放射剂量（D0.1ml）是最佳的放射相关预测参数。多因素分析表明，CCD、SOM和耳蜗的D0.1ml（分别为P = 0.035、0.012和0.022）是与SNHL相关的因素。
对于接受IMRT和化疗的NPC患者，治疗相关SNHL的发生率与CCD、耳蜗的D0.1ml和SOM有关。
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