Dosimetric parameters associated with conductive or sensorineural hearing loss 5 years after intensity-modulated radiation therapy in nasopharyngeal carcinoma

Zhu, Wenjia; Chen, Fu; Li, Ji; Wang, Weifang; Zhang, Haiyan; Yang, Gang; Zou, Lifen; Zhu, Yi; Yuan, Wei; Ding, Hao; Song, Xinmao; Wang, Shengzi

doi:10.1080/00016489.2019.1566778

Cited by 12 publications

(7 citation statements)

References 20 publications

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“…In our modeling, the occurrence of neurosensorial hearing loss was set for the majority of patients with NPC (including all T2-4N0-3 diseases) who should receive cisplatin-based concurrent chemotherapy as a part of their radical treatment. The use of cisplatin may also induce an irreversible ototoxicity, thereby increasing the absolute risk of irradiationrelated hearing loss 29,[32][33][34] ; however, the use or nonuse of cisplatin would not affect our evaluation for the benefits of IMPT over IMRT in reducing the neurosensorial hearing loss. Second, the HSUVs applied for "dysphagia and hearing loss," "xerostomia and hearing loss," and "dysphagia, xerostomia and hearing loss" (0.579, 0.622, and 0.539) in our study were the lower limit values derived from the established HSUVs for "dysphagia," "xerostomia," "hearing loss," "dysphagia and xerostomia."…”

Section: Discussionmentioning

confidence: 99%

“…7,9 In the Markov model of IMRT strategy, the occurrences of dysphagia and xerostomia were set according to the longterm follow-up results reported by Huang et al, in which the incidences of dysphagia and xerostomia (≥grade 2) after IMRT were 0.22 and 0.34, respectively 12 ; and the incidence of high-frequency sensorineural hearing loss was set as 0.35 from the 1st to the 3rd year to simulate the plateau, which then increased with a same annual rate in the following 10 years until it reached to the maximum incidence of 0.446 in the 13st year. 29,[32][33][34] Based on the above setups for late toxicities in the IMRT strategy, the late toxicities probabilities in the IMPT strategy were calibrated to measure up to a preset NTCP-reduction level (e.g., 10%, 20%, 30%, 40%, 50%, or 60%). Initially, we assumed that IMPT could provide an NTCP reduction of 30% in dysphagia, xerostomia, and sensorineural hearing loss for the base case.…”

Section: Setups For Base Casementioning

confidence: 99%

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Intensity‐modulated proton radiation therapy as a radical treatment modality for nasopharyngeal carcinoma in China: Cost‐effectiveness analysis

et al. 2021

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Background: Compared to conventional intensity-modulated photon radiation therapy (IMRT), intensity-modulated proton radiation therapy (IMPT) has potential to reduce irradiation-induced late toxicities while maintaining excellent tumor control in patients with nasopharyngeal carcinoma (NPC). However, the relevant cost-effectiveness remains controversial.Methods: A Markov decision tree analysis was performed under the assumption that IMPT offered normal tissue complication probability reduction (NTCP reduction) in long-term dysphagia, xerostomia, and hearing loss, compared to IMRT. Base-case evaluation was performed on T2N2M0 NPC of median age (43 years old). A Chinese societal willingness-to-pay threshold

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Section: Discussionmentioning

confidence: 99%

Section: Setups For Base Casementioning

confidence: 99%

Intensity‐modulated proton radiation therapy as a radical treatment modality for nasopharyngeal carcinoma in China: Cost‐effectiveness analysis

et al. 2021

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“…In terms of late toxicities, 2 (22%) long-term survivors developed ≥grade 3 toxicities. Severe cataracts [ 17 ], optic nerve disorder [ 18 ], and hearing impairment [ 19 ] has often been reported with photon RT. Since the tumors in the 2 patients in our cohort were near the optic nerve, eyeball and auditory nerve, these toxicities were considered inevitable to achieve tumor control.…”

Section: Discussionmentioning

confidence: 99%

Phase I dose-escalation trial of S-1 combined with carbon-ion radiotherapy for sinonasal squamous cell carcinoma

Takahashi

Demizu

Park

et al. 2020

Journal of Radiation Research

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Abstract This study aimed to determine the maximum tolerance dose (MTD) and to estimate the recommended dose (RD) of concomitant S-1 with carbon-ion radiotherapy (RT) for sinonasal squamous cell carcinoma (SCC). Nine patients with sinonasal SCC received carbon-ion RT with escalating doses of S-1 according to phase I methods. Doses of 40, 60 and 80 mg/m2/day were administered twice daily in dose levels 1, 2 and 3, respectively, from days 1 to 14 and 22 to 35. Carbon-ion RT was administered at a dose of 70.4 Gy (relative biological effectiveness) in 32 fractions, 5 days a week. Two patients developed grade 3 acute dermatitis. However, none developed dose-limiting toxicities. Therefore, the MTD of S-1 could not be determined; the RD was estimated to be 80 mg/m2/day with concurrent carbon-ion RT. Partial response and stable disease were noted in 5 and 4 patients, respectively. The 2-year overall survival and local control rates were 56 and 74%, respectively. Overall, 2 patients developed ≥grade 3 late toxicities; among them, 1 patient developed grade 3 cataract and the other developed grade 4 cataract, optic nerve disorder and hearing impairment. To the best of our knowledge, this phase I study is the first clinical trial to evaluate concomitant S-1 with carbon-ion RT for sinonasal SCC. The MTD of S-1 could not be determined, and the RD was estimated to be 80 mg/m2/day. This study demonstrated a manageable safety profile for this combination. The observed outcomes may facilitate further evaluation of this novel therapy.

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“…A recent study found that the effect of fractionated stereotactic radiotherapy (fSRT) on the total dose of cochlea may be less than that of stereotactic radiosurgery (SRS) [ 74 ]. Studies have also shown that NPC patients have an increased risk of developing high-frequency SNHL when the radiation dose to internal auditory canal (IAC) was IAC − D max > 42.13 Gy or IAC − D mean > 32.71 Gy [ 75 ]. Hence, reducing the cochlear dose seems to be critical to reducing the incidence of SNHL [ 73 ].…”

Section: Protection Measuresmentioning

confidence: 99%

Mechanism and Protection of Radiotherapy Induced Sensorineural Hearing Loss for Head and Neck Cancer

Shi

Hou

Bao

et al. 2021

BioMed Research International

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Purpose. Radiotherapy-induced sensorineural hearing loss (RISNHL) is a common adverse effect in patients with head and neck cancer. Given that there are few studies on the pathogenesis of RISNHL at present, we summarized the possible pathogenesis of RISNHL and possible protective measures found at present by referring to relevant literatures. Methods. We performed a comprehensive literature search in the PubMed database, using keywords “sensorineural hearing loss,” “radiotherapy,” and “cancer,” among others. The literature was examined for the possible mechanism and preventive measures of sensorineural hearing loss induced by radiotherapy. Results. We found that the incidence of RISNHL was closely related to the damage directly caused by ionizing radiation and the radiation-induced bystander effect. It also depends on the dose of radiation and the timing of chemotherapy. Studies confirmed that RISNHL is mainly involved in post-RT inflammatory response and changes in reactive oxygen species, mitogen-activated protein kinase, and p53 signaling pathways, leading to specific manners of cell death. We expect to reduce the incidence of hearing loss through advanced radiotherapy techniques, dose limitation of organs at risk, application of cell signaling inhibitors, use of antioxidants, induction of cochlear hair cell regeneration, and cochlear implantation. Conclusion. RISNHL is associated with radiation damage to DNA, oxidative stress, and inflammation of cochlear cells, stria vascularis endothelial cells, vascular endothelial cells, spiral ganglion neurons, and other supporting cells. At present, the occurrence mechanism of RISNHL has not been clearly illustrated, and further studies are needed to better understand the underlying mechanism, which is crucial to promote the formulation of better strategies and prevent the occurrence of RISNHL.

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Dosimetric parameters associated with conductive or sensorineural hearing loss 5 years after intensity-modulated radiation therapy in nasopharyngeal carcinoma

Cited by 12 publications

References 20 publications

Intensity‐modulated proton radiation therapy as a radical treatment modality for nasopharyngeal carcinoma in China: Cost‐effectiveness analysis

Intensity‐modulated proton radiation therapy as a radical treatment modality for nasopharyngeal carcinoma in China: Cost‐effectiveness analysis

Phase I dose-escalation trial of S-1 combined with carbon-ion radiotherapy for sinonasal squamous cell carcinoma

Mechanism and Protection of Radiotherapy Induced Sensorineural Hearing Loss for Head and Neck Cancer

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