Risk Factors of Ototoxicity After Cisplatin-Based Chemo-Irradiation in Patients With Locally Advanced Head-and-Neck Cancer: A Multivariate Analysis

Risk Factors for Hearing Loss in Patients Treated With Intensity-Modulated Radiotherapy for Head-and-Neck Tumors

“…However, at ultra-high frequencies, the effect of RT in the present study was larger than that observed in our highdose cisplatin chemoradiation regimen, because the radiation effect in the CRT regimen might have been masked by the extensive adverse effect of cisplatin at ultra-high frequencies (26). Although radiation-induced vascular insufficiency has been proposed as the etiology of SNHL (27,28), in animal models, radiation and cisplatin both affected similar targets in the cochlea, including hair cells, stria vascularis, and afferent nerve endings, from basal to apical windings with increasing dose (27)(28)(29)(30)(31)(32)(33).…”

“…Finally, in this analysis, RT resulted in less SNHL at speech frequencies compared with the radiation effect observed in a previous multivariate analysis of our institute concerning concurrent high-dose cisplatin chemoradiotherapy (26). However, at ultra-high frequencies, the effect of RT in the present study was larger than that observed in our highdose cisplatin chemoradiation regimen, because the radiation effect in the CRT regimen might have been masked by the extensive adverse effect of cisplatin at ultra-high frequencies (26).…”

Prediction of Hearing Loss Due to Cisplatin Chemoradiotherapy

“…In the past, patients with severe hearing loss at baseline were often withdrawn from a cisplatin-based treatment regimen owing to the assumption that ototoxicity would have too much negative effect on their hearing. However, the study of Zuur et al 8 caused a paradigm shift, demonstrating that patients with a severe hearing loss at baseline will lose less in terms of decibels compared with patients with an excellent baseline hearing level. Still, the exact hearing loss per patient remains unknown, making the development of a prediction model desirable.…”

Ototoxicity After Intensity-Modulated Radiation Therapy and Cisplatin-Based Chemotherapy in Children With Medulloblastoma

“…A recent multi-institutional study of 97 children who underwent cisplatin-based chemotherapy and three-dimensional conformal RT boost showed that 22 (22.7%) patients had Grade 3 or 4 ototoxicity (8). Table 3 summarizes the existing literature on ototoxicity with RT and cisplatin-based chemotherapy and also selected series in nasopharyngeal and other head-and-neck carcinoma (4,8,(12)(13)(14)(15)(16)(17). Our results are in agreement with what is published in the literature, with about 25% of patients have severe hearing loss after cochlear-sparing RT and cisplatinbased chemotherapy (8,14,15).…”