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儿科肿瘤患者放疗相关的感音神经性听力损失。

Radiotherapy-associated Sensorineural Hearing Loss in Pediatric Oncology Patients.

机构信息

Department of Emergency Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.

Department of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.

出版信息

Curr Med Chem. 2024;31(33):5351-5369. doi: 10.2174/0929867330666230515112245.

Abstract

During the radiotherapeutic treatment of pediatric oncology patients, they would be at a latent risk of developing ionizing radiation-induced ototoxicity when the cochlea or auditory nerve is located within the radiation field. Sensorineural hearing loss (SNHL) is an irreversible late complication of radiotherapy, and its incidence depends on various factors such as the patient's hearing sensitivity, total radiation dose to the cochlea, radiotherapy fractionation regimen, age and chemoradiation. Importantly, this complication exhibits serious challenges to adult survivors of childhood cancer, as it has been linked to impairments in academic achievement, psychosocial development, independent living skills, and employment in the survivor population. Therefore, early detection and proper management can alleviate academic, speech, language, social, and psychological morbidity arising from hearing deficits. In the present review, we have addressed issues such as underlying mechanisms of radiation-induced SNHL, audiometric findings of pediatric cancer patients treated with radiotherapy, and management and protection measures against radiation-induced ototoxicity.

摘要

在儿科肿瘤患者的放射治疗过程中,如果耳蜗或听神经位于辐射野内,他们将处于潜在的电离辐射诱导性耳毒性风险中。感音神经性听力损失(SNHL)是放疗的一种不可逆转的晚期并发症,其发生率取决于患者的听力敏感度、耳蜗接受的总辐射剂量、放疗分割方案、年龄和放化疗等多种因素。重要的是,这种并发症对儿童癌症成年幸存者构成了严重挑战,因为它与学术成就、社会心理发展、独立生活技能和幸存者人群中的就业受损有关。因此,早期发现和适当的管理可以减轻听力缺陷引起的学业、言语、语言、社会和心理发病。在本综述中,我们讨论了放射诱导 SNHL 的潜在机制、接受放疗的儿科癌症患者的听力测试结果,以及针对放射诱导性耳毒性的管理和保护措施等问题。

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