Long-Term Hearing Results and Otological Complications of Nasopharyngeal Carcinoma Patients: Comparison between Treatment with Conventional Two-Dimensional Radiotherapy and Intensity-Modulated Radiotherapy

Abstract

Objective: To assess the long-term audiological outcome and otological complications of nasopharyngeal carcinoma patients who have received intensity-modulated radiotherapy (IMRT) versus conventional two-dimensional radiotherapy (2 DRT). Study Design: Prospective study on the audiological outcome and otological complications 5–9 years after radiotherapy. Methodology: Patients had pure-tone audiogram before radiotherapy and 5 years after radiotherapy. Otological examination was performed 5–9 years after radiotherapy by an otolaryngologist. Results: There is a significant deterioration of the hearing threshold 5 years after radiotherapy but there is no statistically significant difference in the deterioration of hearing between IMRT and 2 DRT. Six patients in the 2 DRT group and 1 patient in the IMRT group had osteoradionecrosis of the external auditory canal (p = 0.042). Conclusion: There are fewer incidences of osteoradionecrosis of the external auditory canal in patients treated with IMRT. There is no difference in bone conduction threshold in patients treated with IMRT or 2 DRT.

Sensorineural hearing loss in patients with head and neck cancer after chemoradiotherapy and radiotherapy: A systematic review of the literature

“…The characteristics of the included studies are shown in Table . Most of the studies were prospective (16 of 21).…”

“…Various RT techniques were used in the studies included: 3D conformal, conventional, and intensity‐modulated radiation therapy (IMRT). In some studies, different treatment schedules were used . In 15 studies, the dose to the cochlea was measured, with mean cochlear dose varying from 10.56 to 69.6 Gray (Gy).…”

Cochlea sparing effects of intensity modulated radiation therapy in head and neck cancers patients: A long-term follow-up study

“…A recent long-term follow-up study of Tsang et al studied patients with nasopharyngeal cancer (NPC) treated with IMRT or conventional therapy on their long-term hearing status (56 ears) [ 21 ]. They concluded that there was a BC threshold shift of 16.1 dB at 4 kHz 5 years after IMRT treatment and that this deterioration, in general, could not be attributed to ageing alone.…”

Submandibular Gland Transfer for the Prevention of Postradiation Xerostomia in Patients with Head and Neck Cancer: A Systematic Review and Meta-Analysis

“…To date, many therapeutic agents including saliva substitutes [26], intensity-modulated radiotherapy [27,28], pilocarpine [29,30,31,32], acupuncture [33,34], and amifostine [35,36] had been available to alleviate radiation-induced xerostomia, but they rarely had curable effects or were even controversial regarding the safety of their use. So, the best method to treat postradiation xerostomia would be to choose preventive measures.…”