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Adverse Cochlear Effects After Head and Neck Cancer Therapy

  • Vanita SarinEmail author
Original Article
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Abstract

This study aims to report the incidence of adverse cochlear effects when treating patients of HNSCC with different radiation techniques and to compare the effect of different treatment modalities on the cochlea. This prospective observational study took place in a tertiary care centre, of 132 individual ears from 66 patients of HNSCC treated with conventional RT (group-1), IMRT (group-2), conventional RT with chemotherapy (group-3) and IMRT in combination with chemotherapy (group-4). Pure tone audiometry was performed during the follow-up period at 3 months and 1 year of completion of therapy. Correlation of audiometric change of both the ears at high frequencies (pure tone average 4 kHz, 6 kHz, 8 kHz), low frequencies (pure tone average 0.5–2 kHz) and BC (average 500–4 kHz) with series of factors were analyzed. There was a significant deterioration of hearing threshold 1 year after complete treatment, in all groups. There was an average drop in BC (0–1 year) by 19.63 ± 31.25% in group-2, 24.57 ± 21.96% in group-1 and a drop of 36.48 ± 43.97% and 70.78 ± 21.11% in group-3 and group-4 respectively. When we compared the audiometric change (PTAv at high and low frequency) from 0 to 1 year of group-1&2 the p value was significant (p = 0.050 at high frequency, p = 0.040 at low frequency). The audiological outcome of the different treatment modalities when compared, it was observed that the maximum hearing loss was in group-4 (IMRT with Chemotherapy) followed by group-3 (RTCT), group-1 (Conventional RT) and group-2 (IMRT).

Keywords

Sensorineural Squamous cell carcinoma Radiation Chemotherapy IMRT Pure tone audiometry 

References

  1. 1.
    Bhandare N, Jackson A, Eisbruch A, Pan CC, Flickinger JC, Antonelli P, Mendenhall WM (2010) Radiation therapy and hearing loss. Int J Radiat Oncol Biol Phys 76:S50–S57CrossRefGoogle Scholar
  2. 2.
    Pignon JP, le Maitre A, Maillard E (2009) Bourhis J; MACH-NC Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 92:4–14CrossRefGoogle Scholar
  3. 3.
    Janjira P, Achariyaporn S, Kukklathorn T, Phawin K, Kanthong T, Yaowalak C, Pattaranutaporn P (2011) Sensorineural hearing loss after concurrent chemoradiotherapy in nasopharyngeal cancer patients. Radiat Oncol 6(19):2–8Google Scholar
  4. 4.
    Jensen AB, Hansen O, Jorgensen K, Bastholt L (1994) Influence of late side-effects upon daily life after radiotherapy for laryngeal and pharyngeal cancer. Acta Oncol 33:487–491CrossRefGoogle Scholar
  5. 5.
    Bjordal K, Kaasa S (1995) Psychological distress in head and neck cancer patients 7–11 years after curative treatment. Br J Cancer 71:592–597CrossRefGoogle Scholar
  6. 6.
    Mujica-Mota M, Waissbluth S, Daniel SJ (2013) Characteristics of radiation-induced sensorineural hearing loss in head and neck cancer: a systematic review. Head Neck 35:1662–1668CrossRefGoogle Scholar
  7. 7.
    Theunissen EA, Bosma SC, Zuur CL, Spijker R, Van der Baan S, Dreschler WA, de Boer JP, Balm AJ, Rasch CR (2013) Sensorineural hearing loss in patients with head and neck cancer after chemoradiotherapy and radiotherapy: a systematic review of the literature. Head Neck.  https://doi.org/10.1002/hed.23551[Epub ahead of print] CrossRefGoogle Scholar
  8. 8.
    Wolden SL, Chen WC, Pfister DG, Kraus DH, Berry SL, Zelefsky MJ (2006) Intensity-modulated radiation therapy (IMRT) for nasopharynx cancer: update of the Memorial Sloan-Kettering experience. Int J Radiat Oncol Biol Phys 64:57–62CrossRefGoogle Scholar
  9. 9.
    Peng G, Wang T, Yang KY, Zhang S, Zhang T, Li Q, Han J, Wu G (2012) A prospective, randomized study comparing outcomes and toxicities of intensity-modulated radiotherapy vs. conventional two-dimensional radiotherapy for the treatment of nasopharyngeal carcinoma. Radiother Oncol 104:286–293CrossRefGoogle Scholar
  10. 10.
    Vanasek J, Odrazka K, Dusek L et al (2013) Experience with intensity-modulated radiotherapy in the treatment of head and neck cancer. J BUON 18:970–976PubMedGoogle Scholar
  11. 11.
    Zygogianni A, Kyrgias G, Kouvaris J et al (2012) Impact of acute radiation induced toxicity of glutamine ad-ministration in several hypofractionated irradiation schedules for head and neck carcinoma. Head Neck Oncol 4:86Google Scholar
  12. 12.
    Grégoire V, Ang K, Budach W et al (2014) Delineation of the neck node levels for head and neck tumors: a 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines. Radiother Oncol 110:172–181CrossRefGoogle Scholar
  13. 13.
    Marks LB, Yorke ED, Jackson A et al (2010) Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys 76:S10–S19CrossRefGoogle Scholar
  14. 14.
    Bentzen SM, Constine LS, Deasy JO et al (2010) Quantitative analyses of normal tissues effects in the clinic (QUAN-TEC): an introduction to the scientific issues. Int J Radiat Oncol Biol Phys 76:S3–S9CrossRefGoogle Scholar
  15. 15.
    Kwong DL, Wei WI, Sham JS, Ho WK, Yuen PW, Chua DT, Au DK, Wu PM, Choy DT (1996) Sensorineural hearing loss in patients treated for nasopharyngeal carcinoma: a prospective study of the effect of radiation and cisplatin treatment. Int J Radiat Oncol Biol Phys 36(2):281–289CrossRefGoogle Scholar
  16. 16.
    Ho WK, Wei WI, Kwong DL, Sham JS, Tai PT, Yuen AP, Au DK (1999) Long-term sensorineural hearing deficit following radiotherapy in patients suffering from nasopharyngeal carcinoma: a prospective study. Head Neck 21(6):547–553CrossRefGoogle Scholar
  17. 17.
    Jereczek-Fossa BA, Zarowski A, Milani F, Orecchia R (2003) Radiotherapy-induced ear toxicity. Cancer Treat Rev 29(5):417–430CrossRefGoogle Scholar
  18. 18.
    Low WK, Tan MG, Chua AW, Sun L, Wang DY (2009) 12th Yahya Cohen memorial lecture: the cellular and molecular basis of radiation-induced sensorineural hearing loss. Ann Acad Med Singap 38(1):91–94PubMedGoogle Scholar
  19. 19.
    Tsang RK, Kwong DL, Ho AC, To VS, Ho WK, Wei WI (2012) Long-term hearing results and otological complications of nasopharyngeal carcinoma patients: comparison between treatment with conventional two-dimensional radiotherapy and intensity-modulated radiotherapy. ORL. J Otorhinolaryngol Relat Spec 74:228–233CrossRefGoogle Scholar
  20. 20.
    Theunissen EA, Zuur CL, Yurda ML, van der Baan S, Kornman AF, Paul J, de Boer AJ, Balm C, Rasch RN, Dreschler WA (2014) Cochlea sparing effects of intensity modulated radiation therapy in head and neck cancers patients: a long-term follow-up study. J Otolaryngol Head Neck Surg 43:30CrossRefGoogle Scholar
  21. 21.
    Hitchcock YJ, Tward JD, Szabo A, Bentz BG, Shrieve DC (2009) Relative contributions of radiation and cisplatin-based chemotherapy to sensorineural hearing loss in head-and-neck cancer patients. Int J Radiat Oncol Biol Phys 73:779–788CrossRefGoogle Scholar
  22. 22.
    Pacholke HD, Amdur RJ, Schmalfuss IM, Louis D, Mendenhall WM (2005) Contouring the middle and inner ear on radiotherapy planning scans. Am J Clin Oncol 28:143–147CrossRefGoogle Scholar
  23. 23.
    Oh YT, Kim CH, Choi JH, Kang SH, Chun M (2004) Sensory neural hearing loss after concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma. Radiother Oncol 72(1):79–82CrossRefGoogle Scholar
  24. 24.
    Hsin CH, Chen TH, Young YH, Liu WS (2010) Comparison of otologic complications between intensity-modulated and two-dimensional radiotherapies in nasopharyngeal carcinoma patients. Otolaryngol Head Neck Surg 143(5):662–668CrossRefGoogle Scholar
  25. 25.
    Chan SH, Ng WT, Kam KL, Lee MCH, Choi CW, Yau TK, Lee AWM (2009) Sensorineural hearing loss after treatment of nasopharyngeal carcinoma: a longitudinal analysis. Int J Radiat Oncol Biol Phys 73(4):1335–1342CrossRefGoogle Scholar
  26. 26.
    Zuur CL, Simis YJ, Lamers EA, Hart AA, Dreschler WA, Balm AJ, Rasch CR (2009) Risk factors for hearing loss in patients treated with intensity-modulated radiotherapy for head and neck tumors. Int J Radiat Oncol Biol Phys 74(2):490–496CrossRefGoogle Scholar
  27. 27.
    Wang J, Chen Y-Y, Tai A, Chen X-L, Huang S-M, Yang C, Bao Y, Li N-W, Deng X-W, Zhao C, Chen M, Allen Li X (2015) Sensorineural hearing loss after combined intensity modulated radiation therapy and cisplatin- based chemotherapy for nasopharyngeal carcinoma. Transl Oncol 8:456–462CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  1. 1.Deptartment of ENTSri Guru Ram Das Institute of Medical Sciences and ResearchAmritsarIndia

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