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

Scobioala, Sergiu; Parfitt, Ross; Matulat, Peter; Kittel, Christopher; Ebrahimi, Fatemeh; Wolters, Heidi; Zehnhoff‐Dinnesen, Antoinette am; Eich, Hans Theodor

doi:10.1007/s00066-017-1205-y

Cited by 17 publications

(24 citation statements)

References 36 publications

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“…When individual medical variables were used to analyze outcome measures, we observed that patients with metastatic disease expressed worse hearing and pain outcomes. Typical standard of care for children with a positive metastatic status involves treatment with higher doses of CSI than those with nonmetastatic disease and CSI is typically associated with poorer hearing outcomes . Extent of resection was also found to have an impact on some single‐attribute utility scores.…”

Section: Discussionmentioning

confidence: 97%

Medulloblastoma has a global impact on health related quality of life: Findings from an international cohort

et al. 2019

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Background: Understanding the global impact of medulloblastoma on health related quality of life (HRQL) is critical to characterizing the broad impact of this disease 448 | and realizing the benefits of modern treatments. We evaluated HRQL in an international cohort of pediatric medulloblastoma patients. Methods: Seventy-six patients were selected from 10 sites across North America, Europe, and Asia, who participated in the Medulloblastoma Advanced Genomics International Consortium (MAGIC). The Health Utilities Index (HUI) was administered to patients and/or parents at each site. Responses were used to determine overall HRQL and attributes (ie specific subdomains). The impact of various demographic and medical variables on HRQL was considered-including molecular subgroup. Results: The majority of patients reported having moderate or severe overall burden of morbidity for both the HUI2 and HUI3 (HUI2 = 60%; HUI3 = 72.1%) when proxy-assessed. Self-care in the HUI2 was rated as higher (ie better outcome) for patients from Western versus Eastern sites, P = .02. Patients with nonmetastatic status had higher values (ie better outcomes) for the HUI3 hearing, HUI3 pain, and HUI2 pain, all P < .05. Patients treated with a gross total resection also had better outcomes for the HUI3 hearing (P = .04). However, those who underwent a gross total resection reported having worse outcomes on the HUI3 vision (P = .02). No differences in HRQL were evident as a function of subgroup. Conclusions: By examining an international sample of survivors, we characterized the worldwide impact of medulloblastoma. This is a critical first step in developing global standards for evaluating long-term outcomes. K E Y W O R D S development, medulloblastoma, pediatric psychology, quality of life, survivors of childhood cancer Abbreviations: ε 2 , epsilon-squared; SD, standard deviation. *Indicates a statistically significant difference (P ≤ .05).

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Section: Discussionmentioning

confidence: 97%

Medulloblastoma has a global impact on health related quality of life: Findings from an international cohort

et al. 2019

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“…[44][45][46] The incidence can increase up to 90% in patients concomitantly treated with cisplatin. 47 Onset of SNHL is typically delayed and can occur 3 months to 13 years post-RT. 44,48 Progressive deterioration of hearing and increased incidence rates of hearing loss may be observed with longer follow-up.…”

Section: Sensorineural Hearing Lossmentioning

confidence: 99%

Challenges of Hearing Rehabilitation after Radiation and Chemotherapy

Nader

Gidley

2019

J Neurol Surg B

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Radiation and chemotherapy are frequently used in the treatment of head and neck malignancies. Ototoxicity is a common adverse effect of these treatment modalities. This article discusses the patterns of hearing loss following chemotherapy and radiation therapy. Specific issues related to hearing rehabilitation in oncological patients will also be covered, such as controversies regarding treatment of radiation-induced serous otitis media, risks of otologic surgery, and the use of osseointegrated hearing aids and cochlear implants.

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“…With increasing improvements of local control rate and overall survival [ 1 ], the management of late toxicities becomes more important [ 2 ]. Due to the tumor location, hearing impairment is a common and well-described complication after treatment [ 3 ]. Although this toxicity mostly depends on the radiation dose to the cochlea, only limited data for the relation between radiation dose and hearing impairment is available.…”

Section: Introductionmentioning

confidence: 99%

Cochlea sparing optimized radiotherapy for nasopharyngeal carcinoma

Lamaj

Timmeren

et al. 2021

Radiat Oncol

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Background Definitive chemoradiotherapy (CRT) is standard of care for nasopharyngeal carcinoma. Due to the tumor localization and concomitant platinum-based chemotherapy, hearing impairment is a frequent complication, without defined dose-threshold. In this study, we aimed to achieve the maximum possible cochleae sparing. Materials and methods Treatment plans of 20 patients, treated with CRT (6 IMRT and 14 VMAT) based on the QUANTEC organs-at-risk constraints were investigated. The cochleae were re-delineated independently by two radiation oncologists, whereas target volumes and other organs at risk (OARs) were not changed. The initial plans, aiming to a mean cochlea dose < 45 Gy, were re-optimized with VMAT, using 2–2.5 arcs without compromising the dose coverage of the target volume. Mean cochlea dose, PTV coverage, Homogeneity Index, Conformity Index and dose to other OAR were compared to the reference plans. Wilcoxon signed-rank test was used to evaluate differences, a p value < 0.05 was considered significant. Results The re-optimized plans achieved a statistically significant lower dose for both cochleae (median dose for left and right 14.97 Gy and 18.47 Gy vs. 24.09 Gy and 26.05 Gy respectively, p < 0.001) compared to the reference plans, without compromising other plan quality parameters. The median NTCP for tinnitus of the most exposed sites was 11.3% (range 3.52–91.1%) for the original plans, compared to 4.60% (range 1.46–90.1%) for the re-optimized plans (p < 0.001). For hearing loss, the median NTCP of the most exposed sites could be improved from 0.03% (range 0–99.0%) to 0.00% (range 0–98.5%, p < 0.001). Conclusions A significantly improved cochlea sparing beyond current QUANTEC constraints is feasible without compromising the PTV dose coverage in nasopharyngeal carcinoma patients treated with VMAT. As there appears to be no threshold for hearing toxicity after CRT, this should be considered for future treatment planning.

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

Cited by 17 publications

References 36 publications

Medulloblastoma has a global impact on health related quality of life: Findings from an international cohort

Medulloblastoma has a global impact on health related quality of life: Findings from an international cohort

Challenges of Hearing Rehabilitation after Radiation and Chemotherapy

Cochlea sparing optimized radiotherapy for nasopharyngeal carcinoma

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