Decreased hearing after combined modality therapy for head and neck cancer

Pearson, Susan E.; Meyer, A. W.; Adams, George L.; Ondrey, Frank G.

doi:10.1016/j.amjoto.2005.07.008

Cited by 23 publications

(24 citation statements)

References 17 publications

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“…In addition, concurrent radiation was found not to be associated with hearing change. However, these findings should be interpreted with caution because concomitant toxins such as noise (Boettcher et al 1987; Gratton et al 1990) and radiation therapy to the head and neck (Chen et al 2006; Pearson et al 2006) have previously been shown to produce a synergistic effect leading to increased rates of ototoxicity. Neither of these two variables was explored in any detail, for example, radiation location was not taken into account.…”

Section: Discussionmentioning

confidence: 99%

Distortion-Product Otoacoustic Emission Test Performance for Ototoxicity Monitoring

et al. 2011

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Introduction A nonbehavioral method for monitoring ototoxicity in patients treated with cisplatin is needed because patients enduring chemotherapy may not be well or cooperative enough to undergo repeated hearing tests. Distortion-product otoacoustic emissions (DPOAEs) provide a nonbehavioral measure of auditory function that is sensitive to cisplatin exposure. However, interpreting DPOAE findings in the context of ototoxicity monitoring requires that their accuracy be determined in relation to a clinically accepted gold standard test. Objectives Among patients receiving cisplatin for the treatment of cancer, we sought to (1) identify the combination of DPOAE metrics and ototoxicity risk factors that best classified ears with and without ototoxic-induced hearing changes; and (2) evaluate the test performance achieved by the composite measure as well as by DPOAEs alone. Design Odds of experiencing hearing changes at a given patient visit were determined using data collected prospectively from 24 Veterans receiving cisplatin. Pure-tone thresholds were examined within an octave of each subject’s high-frequency hearing limit. DPOAE were collected as a set of four response growth (input/output) functions near the highest f2 frequency that yielded a robust response at L2 = L1 = 65 dB SPL. Logistic regression modeled the risk of hearing change using several DPOAE metrics, drug treatment factors, and other patient factors as independent variables. An optimal discriminant function was derived by reducing the model so that only statistically significant variables were included. Receiver operating characteristic curve analyses were used to evaluate test performance. Results At higher cisplatin doses, ears with better hearing at baseline were more likely to exhibit ototoxic hearing changes than those with poorer hearing. Measures of pre-exposure hearing, cumulative drug dose, and DPOAEs generated a highly accurate discriminant function with a cross-validated area under the receiver operating characteristic curve of 0.9. DPOAEs alone also provided an indication of ototoxic hearing change when measured at the highest DPOAE test frequency that yielded a robust response. Conclusions DPOAEs alone and especially in combination with pre-exposure hearing and cisplatin dose provide an indication of whether or not hearing has changed as a result of cisplatin administration. These promising results need to be validated in a separate sample.

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Section: Discussionmentioning

confidence: 99%

Distortion-Product Otoacoustic Emission Test Performance for Ototoxicity Monitoring

et al. 2011

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“…Their results showed that 85% of patients presented changes in frequencies from 4 to 8 kHz and more than 50% of them presented a change equal to or higher than 10 dB [1]. …”

Section: Discussionmentioning

confidence: 99%

“…Auditory damage is one of the main complications of oncological therapy in patients with head and neck tumors [1]. Recently, the addition of chemotherapy (CT) with cisplatin to radiotherapy (RT) has been improving the survival rate of patients with these neoplasias, becoming a standard treatment for tumors locally advanced.…”

Section: Introductionmentioning

confidence: 99%

Audiological findings in patients treated with radio- and concomitant chemotherapy for head and neck tumors

Dell'Aringa

Isaac²,

Arruda

et al. 2009

Radiat Oncol

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ObjectiveTo evaluate the functionality of the auditory system in patients who underwent radiotherapy and chemotherapy treatment with cisplatin to treat head and neck tumors.Study DesignCase series with planned data collection.SettingFrom May 2007 to May 2008 by the Department of Otorhinolaryngology and the Department of Oncology/Radiotherapy at Faculdade de Medicina de Marília.Subjects and MethodsAudiological evaluation (Pure Tone Audiometry (air and bone conduction), Speech Audiometry, Tympanometry, Acoustic Reflex testing and Distortion Product Otoacoustic Emissions) was performed in 17 patients diagnosed with head and neck neoplasia and treated with chemotherapy, using cisplatin, and radiotherapy.Results12 left ears (70.5%) and 11 right ears (64.7%) presented bilateral decreased hearing soon after the treatment for the frequency 1 kHz (mild auditory damage) and for the frequency 8 kHz (more significant auditory damage).ConclusionPatients with head and neck cancer submitted to the conventional radiotherapy treatment, combined with the chemotherapy with cisplatin, presented a high incidence of decreased hearing by the end of treatment. Strong evidence was observed linking auditory alteration to the amount of radiotherapy treatment.

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“…Radiation-induced sensorineural hearing loss (SNHL) has been observed in 49% of patients, immediately after treatment, and has a frequency of 55% at 2 to 8 years after therapy, among patients treated with cranial irradiation that had exposure to the inner ear (Ho et al, 1999;Kwong et al, 1996). In studies on chemoradiation treatment, a 53% frequency SNHL and 14% of ototoxicity have been reported (Pearson et al, 2006;Langenberg et al, 2004). Among patients who received radiotherapy for nasopharyngeal carcinoma, at least one-third developed significant SNHL after treatment (Ho et al, 1999;Kwong et al, 1996).…”

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confidence: 99%

Epicatechin inhibits radiation-induced auditory cell death by suppression of reactive oxygen species generation

Pyun¹,

Kang²,

Hwang³

et al. 2011

Neuroscience

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Decreased hearing after combined modality therapy for head and neck cancer

Cited by 23 publications

References 17 publications

Distortion-Product Otoacoustic Emission Test Performance for Ototoxicity Monitoring

Distortion-Product Otoacoustic Emission Test Performance for Ototoxicity Monitoring

Audiological findings in patients treated with radio- and concomitant chemotherapy for head and neck tumors

Epicatechin inhibits radiation-induced auditory cell death by suppression of reactive oxygen species generation

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