SENSORINEURAL HEARING LOSS AFTER TREATMENT OF NASOPHARYNGEAL CARCINOMA: A LONGITUDINAL ANALYSIS
SENSORINEURAL HEARING LOSS AFTER TREATMENT OF NASOPHARYNGEAL CARCINOMA: A LONGITUDINAL ANALYSIS
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DOI：
10.1016/j.ijrobp.2008.07.034
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发表时间：
2009-04-01
影响因子：
7
通讯作者：
Chow, S. K.
中科院分区：
文献类型：
--
作者：
Chan, S. H.;Ng, W. T.;Chow, S. K.
目的：分析鼻咽癌同期放疗和化疗对感音神经性耳聋(SNHL)的影响。方法与材料：2004-2005年间收治鼻咽癌患者87例，均采用三维适形放疗或调强放疗。在治疗前进行鼓室导纳和纯音测听评估，然后每隔6个月连续进行一次。对耳蜗剂量体数据进行分析。结果：在170只符合条件的耳中，放疗组(n=30)和放化疗组(n=140)持续SNHL的发生率分别为40%(n=12)和56.4%(n=79)。放化疗组高频SNHL的发生率高于单纯放疗组(55%比33.3%，p<；0.01)，但低频SNHL的发生率不高(7.9%比16.7%，p=0.14)。放化疗组中，平均耳蜗量和同期顺铂剂量是高频SNHL的重要影响因素，其OR值分别为1.0 7/Gy值(P=0.0 1)和1.008/mg/m(2)值(P<0.0 1)。年龄、性别和非同期顺铂剂量不是统计学意义上的显著因素。受试者耳蜗骨的平均辐射剂量
Purpose: To analyze the effects of radiotherapy (RT) and chemotherapy in relation to sensorineural hearing loss (SNHL) after contemporary treatment of nasopharyngeal carcinoma.Methods and Materials: A total of 87 nasopharyngeal carcinoma patients were treated with RT or chemoradiotherapy using either three-dimensional conformal RT or intensity-modulated RT between 2004 and 2005. Tympanometry and pure-tone audiogram assessments were performed before treatment and then serially at 6-month intervals. The dose-volume data of the cochlea were analyzed. The effects of cisplatin administered in concurrent and nonconcurrent phases was explored.Results: Of the 170 eligible ears, RT (n = 30) and chemoradiotherapy (n = 140) resulted in 40% (n = 12) and 56.4% (n = 79) persistent SNHL (>= 15 dB loss), respectively, after a median follow-up of 2 years. SNHL at a high frequency was more frequent statistically in the chemoradiotherapy group than in the RT-alone group (55% vs. 33.3%, p < 0.01), but not at a low frequency (7.9% vs. 16.7%, p = 0.14). Within the chemoradiotherapy group, the mean cochlea dose and concurrent cisplatin dose were important determinants of high-frequency SNHL, with an odds ratio of 1.07/Gy increase (p = 0.01) and an odds ratio of 1.008/mg/m(2) increase (p < 0.01), respectively. Age, gender, and nonconcurrent cisplatin dose were not statistically significant factors. A mean radiation dose to the cochlea of