Sensory neural hearing loss after concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma

Oh, Young‐Taek; Kim, Chul‐Ho; Choi, Jin-Hyuk; Kang, Shin-Wook; Chun, Mison

doi:10.1016/j.radonc.2004.02.009

Cited by 64 publications

(70 citation statements)

References 21 publications

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“…Our short-term study further confirmed that the severity of the SNHL is strongly related to the irradiation-absorbed dose-volume; however, there are other studies showing the effects of radiation as well as chemoradiotherapy regime on the hearing loss [6,7]. There are several variables that could have an effect on the risk of developing hearing loss side effects.…”

Section: Discussionsupporting

confidence: 79%

Short-term cohort study on sensorineural hearing changes in head and neck radiotherapy

et al. 2015

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The aim of this study was to investigate the risk of sensorineural hearing loss (SNHL) and the relationship between SNHL and radiation dose to the cochlea and frequency range of hearing loss in patients with head and neck cancer. Pure tone audiometry at 250-12,000 Hz was performed on 29 patients diagnosed with head and neck tumours who were treated with 3-dimensional conformal radiation therapy and followed up for 6 months. Paired t test indicated that the mean air conduction threshold before and after radiotherapy was significantly different (paired t test, p < 0.001). SNHL was observed in 15 patients (51 %) according to CTCAE. SNHL increased to 77 % in patients who had received at least five concurrent cisplatin cycles. There was an increased risk of SNHL for ears receiving a mean dose of 5000 cGy compared to those receiving <5000 cGy. SNHL was more severe at higher frequencies of pure tone audiometry in patients with cisplatin-based chemoradiation. The ototoxicity effect of radiation and cisplatin must be considered in the treatment of head and neck tumours. Increasing the dose of cisplatin, radiation dose of cochlea and follow-up interval time may result in increasing severity and frequency of hearing loss incidences. However, characteristic of radiation-induced SNHL seems to be different from chemoradiation-induced SNHL.

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Section: Discussionsupporting

confidence: 79%

Short-term cohort study on sensorineural hearing changes in head and neck radiotherapy

et al. 2015

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“…There are still arguments about the dosage of cisplatin used in concomitant chemoradiation for head and neck cancers despite several very large, prospective, randomized trials using cisplatin at 100 mg/m 2 proving to have better survival rate than RT alone. Oh et al [16] reported that low dose cisplatin had no additive effect on ototoxicity in nasopharyngeal carcinoma patients who received one cycle of neoadjuvant 5-FU (1000 mg/m 2 ) and cisplatin (20 mg/m 2 ) followed by low dose cisplatin every 3 weeks for 2-3 cycles concurrently during RT. They maintained that the cisplatin dose was too low to induce SNHL by itself.…”

Section: Discussionmentioning

confidence: 99%

Effects of Chemoradiation on Hearing in Patients with Head and Neck Malignancies: Experience at a Tertiary Referral Care Hospital

Jain¹,

Banerjee²,

Dandinarasaiah

2016

Indian J Otolaryngol Head Neck Surg

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Hearing loss as a side effect in patients with head and neck malignancies with chemoradiation is frequently ignored. Its effects on auditory functions are less studied and there are studies done on animals which are less reliable. The present study was undertaken to identify the type of hearing loss and also to quantify the degree of hearing loss in these patients. A prospective, descriptive study was undertaken in histologically proven head and neck cancer patients treated with cobalt 60 teletherapy who received a dose of 60-66 Grays (Gy) over a period of 6-7 weeks with concurrent Cisplatin 30 mg/m 2 once weekly for 6 weeks. The study included 40 patients (80 ears) undergoing chemoradiation. A baseline pure tone audiometry and impedance audiometry was performed in all the cases prior to the therapy and the same was repeated immediately after the completion of treatment, at 8 and 16 weeks. The changes in pure tone level thresholds and impedance from baseline were correlated with the dose of radiation and chemotherapy. Sensori neural hearing loss (SNHL) and conductive hearing loss was observed in 82.5 and 17.5 % respectively. At the end of 16 weeks, SNHL was found in 27.5, 72.5 and 82.5 % at 2, 4 and 8 kHz respectively. In addition, Eustachian tube dysfunction and Otitis media with effusion was observed in 10 and 7.5 % of patients respectively which lead to conductive hearing loss. Further, it was noted that SNHL in patients with high risk site malignancy (81.8 %) was alarmingly higher compared with low risk site malignancy (18.1 %). The hearing loss at 62, 64 and 66 Gy in comparison to 60 Gy was statistically significant. Hearing loss, specially SNHL was the predominant finding in our study with [80 % of patients showing the inner ear damage due to irradiation of head and neck malignancies. Although, all the frequencies like 2, 4 and 8 kHz were significantly affected, SNHL was more marked in the latter two frequencies. Nearly, 90 % of the patients who had SNHL belonged to high risk site category of head and neck malignancies. Increasing the radiation dosage was directly proportional to the degree of hearing loss with the dose more than 60 Gy causing significant injury to the middle and inner ear.

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“…A significant increase in bone conduction threshold at 4 kHz and PTA over 0.5, 1 and 2 kHz was reported 1 and 2 years after RT delivered with concurrent and adjuvant Cisplatin (Low et al 2006). Conversely, no such increase has been seen in patients treated with neoadjuvant cisplatin (Kwong et al 1996;Oh et al 2004;Ho et al 1999) ( Table 9). Though the synergistic effects of cisplatin-based chemotherapy and RT remain debatable, to reduce toxicity restricting the total dose received by the inner ear to a minimal level when delivered with cisplatin-based chemotherapy has been suggested (Combs et al 2006), as has reducing the radiation dose to components of the auditory system to less than 45 Gy (30 Gy more conservatively) , and substituting a less ototoxic agent such as carboplatin (Jacobs et al 1989).…”

Section: Chemoradiationmentioning

confidence: 97%

“…The dose response relationship for the inner ear has been evaluated in a number of prospective and retrospective studies (Honore et al 2002;Pan et al 2005;Oh et al 2004;Chen et al 2006;van der Putten et al 2006). At a total dose as low as 30 Gy for fractionated RT to the head-and-neck region (Raaijmakers and Engelen 2002), SNHL, CHL, or mixed hearing loss (Leach 1965) has been occasionally reported in the literature.…”

Section: Total Dose To the Inner Earmentioning

confidence: 99%

“…When delivered with RT, the effects may depend on both cisplatin and RT dose as well as the chemotherapy regimen (neoadjuvant, adjuvant, or concurrent). Low doses of neoadjuvant cisplatin have not been associated with increasing the incidence of SNHL (Kwong et al 1996;Oh et al 2004;Ho et al 1999). Increased toxicity has been observed in patients treated with both adjuvant and concurrent cisplatin-RT (Bhandare et al 2007;Low et al 2006;Chen et al 2006).…”

Section: Chemoradiationmentioning

confidence: 99%

See 1 more Smart Citation

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et al. 2013

ALERT • Adverse Late Effects of Cancer Treatment

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Sensory neural hearing loss after concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma

Cited by 64 publications

References 21 publications

Short-term cohort study on sensorineural hearing changes in head and neck radiotherapy

Short-term cohort study on sensorineural hearing changes in head and neck radiotherapy

Effects of Chemoradiation on Hearing in Patients with Head and Neck Malignancies: Experience at a Tertiary Referral Care Hospital

Radiation-Induced Ototoxicity

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