Intensity-modulated radiation therapy for pediatric medulloblastoma: early report on the reduction of ototoxicity

Huang, Eugene; Teh, Bin S.; Strother, Douglas; DAVIS, Q; Chiu, J. Kam; Lu, Haiquan; Carpenter, L. Steven; Yuan, Wei; Chintagumpala, Murali; South, Michael S.; Grant, Walter H.; Butler, E. Brian; Woo, Shiao Y.

doi:10.1016/s0360-3016(01)02641-4

Cited by 224 publications

(140 citation statements)

References 31 publications

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“…The only way to reduce the incidence of SNHL is to minimize the radiation dose to inner ear [5,6,8,16]. Radiation dose to inner ear is the most important factor for hearing damage [5,16] and treatment with IMRT can achieve a lower rate of hearing loss, from 64 to 13% [6].…”

Section: Discussionmentioning

confidence: 99%

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

Kim

Choi

et al. 2004

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 99%

“…Radiation dose to inner ear is the most important factor for hearing damage [5,16] and treatment with IMRT can achieve a lower rate of hearing loss, from 64 to 13% [6]. During the later study period, we used three-dimensional techniques from start and could reduce the radiation dose to inner ear from 69.6^11.8 to 63.4^9.1 Gy.…”

Section: Discussionmentioning

confidence: 99%

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

Kim

Choi

et al. 2004

Radiotherapy and Oncology

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“…IMRT has been used to lessen the radiation dose to the temporal lobes and reduce radiation exposure to the cochlea by approximately 40%, resulting in decreased ototoxicity (7). In a previous report from our institutions, IMRT was shown to decrease ototoxicity despite the use of cisplatin chemotherapy compared with conventional RT (7).…”

Section: Introductionmentioning

confidence: 99%

Changes Mimicking New Leptomeningeal Disease After Intensity-Modulated Radiotherapy for Medulloblastoma

Muscal

Jones

Paulino

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

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Purpose-Acute and late changes in magnetic resonance imaging of the pediatric brain have been described after radiotherapy (RT). We report the post-RT neuroimaging changes in the posterior fossa after intensity-modulated RT (IMRT) in children with medulloblastoma and contrast them with those of leptomeningeal disease.Methods and Materials-We performed a retrospective review of 53 consecutive children with medulloblastoma who were treated with craniospinal RT followed by IMRT to the posterior fossa and chemotherapy between 1997 and 2006.Results-After IMRT to the posterior fossa, 8 (15%) of 53 patients developed increased fluidattenuated inversion-recovery signal changes in the brainstem or cerebellum and patchy, multifocal, nodular contrast enhancement at a median of 6 months. The enhancement superficially resembled leptomeningeal disease. However, the enhancement resolved without intervention at a median of 6 months later. The accompanying fluid-attenuated inversion-recovery signal changes occasionally preceded the enhancement, were often parenchymal in location, and resolved or persisted to a lesser degree. All 8 patients with transient magnetic resonance imaging changes in the posterior fossa were alive at last follow-up. In contrast, leptomeningeal disease occurred in 8 (15%) of our 53 patients at a median of 19.5 months after IMRT completion. Of these 8 patients, 7 demonstrated initial nodular enhancement outside the conformal field, and 7 patients died.Conclusion-Magnetic resonance imaging changes can occur in the posterior fossa of children treated with IMRT for medulloblastoma. In our experience, these transient changes occur at a characteristic time and location after RT, allowing them to be distinguished from leptomeningeal disease.

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“…In 1999, the Pediatric Oncology Group Toxicity -POGT (Huang et al, 2002) 14 developed a hearing loss classification for children treated with chemotherapeutic agents. This classification also classifies the loss in levels: Level 0 (normal hearing), Level 1 (hearing loss between 20 and 40 dBHL in frequencies above 4000 Hz), Level 2 (hearing loss above or equal to 40 dBHL in frequencies above or equal to 4000 Hz), Level 3 (hearing loss above or equal to 40 dBHL in frequencies above 2000 Hz) and Level 4 (hearing loss above or equal to 40 dBHL in 2000 Hz and below).…”

Section: Introductionmentioning

confidence: 99%

A prevalência de perdas auditivas em crianças e adolescentes com câncer

Silva

Latorre

Cristófani

et al. 2007

Rev. Bras. Otorrinolaringol.

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The treatment of cancer in children has several side effects, including ototoxicity. Inner ear structures may be affected and hearing loss may ensue. Aim: To estimate the prevalence of hearing loss in patients with cancer using the American Speech-Language-Hearing Association (ASHA), the Pediatric Oncology Group Toxicity (POGT), and the Bilateral Hearing Loss (PAB) criteria. Study design: a prospective study. Material and Methods: 94 patients admitted between 2003 and 2004 were analyzed. Visual inspection of the external auditory meatus and an audiologic evaluation were done. Descriptive statistics was used to characterize the sample, and Kappa statistics was used to investigate concordance of hearing loss in the three types of classification. Results: The prevalence of hearing loss was 42.5% using ASHA, 40.4% using POGT, and 12.8% using PAB. The concordance of hearing loss was weak for POGT and PAB (k=0.36) and for PAB and ASHA (k=0.33). The concordance between ASHA and POGT was almost perfect (k=0.96). Conclusions: Hearing loss is an important side effect of the treatment of cancer in children. Periodic audiology monitoring is recommended to detect early hearing loss and to revise the treatment if necessary. Adoption of a classification system that detects mild hearing loss (ASHA) is recommended.

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Intensity-modulated radiation therapy for pediatric medulloblastoma: early report on the reduction of ototoxicity

Cited by 224 publications

References 31 publications

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

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

Changes Mimicking New Leptomeningeal Disease After Intensity-Modulated Radiotherapy for Medulloblastoma

A prevalência de perdas auditivas em crianças e adolescentes com câncer

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