Impact of radiation technique, radiation fraction dose, and total cisplatin dose on hearing

Purpose To analyze the incidence and degree of sensorineural hearing loss (SNHL) resulting from different radiation techniques, fractionation dose, mean cochlear radiation dose ($ D_{mean} $), and total cisplatin dose. Material and methods In all, 29 children with medulloblastoma (58 ears) with subclinical pretreatment hearing thresholds participated. Radiotherapy (RT) and cisplatin had been applied sequentially according to the HIT MED Guidance. Audiological outcomes up to the latest follow-up (median 2.6 years) were compared. Results Bilateral high-frequency SNHL was observed in 26 patients (90%). No significant differences were found in mean hearing threshold between left and right ears at any frequency. A significantly better audiological outcome (p < 0.05) was found after tomotherapy at the 6 kHz bone-conduction threshold (BCT) and left-sided 8 kHz air-conduction threshold (ACT) than after a combined radiotherapy technique (CT). Fraction dose was not found to have any impact on the incidence, degree, and time-to-onset of SNHL. Patients treated with CT had a greater risk of SNHL at high frequencies than tomotherapy patients even though $ D_{mean} $ was similar. Increase in severity of SNHL was seen when the total cisplatin dose reached above 210 mg/$ m^{2} $, with the highest abnormal level found 8–12 months after RT regardless of radiation technique or fraction dose. Conclusion The cochlear radiation dose should be kept as low as possible in patients who receive simultaneous cisplatin-based chemotherapy. The risk of clinically relevant HL was shown when $ D_{mean} $ exceeds 45 Gy independent of radiation technique or radiation regime. Cisplatin ototoxicity was shown to have a dose-dependent effect on bilateral SNHL, which was more pronounced in higher frequencies..

Medienart:

Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:193

Enthalten in:

Strahlentherapie und Onkologie - 193(2017), 11 vom: 08. Sept., Seite 910-920

Sprache:

Englisch

Beteiligte Personen:

Scobioala, Sergiu [VerfasserIn]
Parfitt, Ross [VerfasserIn]
Matulat, Peter [VerfasserIn]
Kittel, Christopher [VerfasserIn]
Ebrahimi, Fatemeh [VerfasserIn]
Wolters, Heidi [VerfasserIn]
am Zehnhoff-Dinnesen, Antoinette [VerfasserIn]
Eich, Hans Theodor [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Bone conduction
Cochlea
Fraction dose
Hearing loss, sensorineural
Radiotherapy, intensity-modulated

Anmerkungen:

© Springer-Verlag GmbH Deutschland 2017

doi:

10.1007/s00066-017-1205-y

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2045815129