目的:研究放化疗对头颈部恶性肿瘤患者听力的影响。
方法:接受顺铂以外药物治疗的患者以及有任何耳科相关病理或异常的患者被排除在研究之外。经活检证实为鼻咽部恶性肿瘤的患者,口咽喉,鼻旁窦,口腔,腮腺顺铂放化疗和不同放射方式均符合条件。在CT图像上显示感兴趣区域和OAR。所有患者的听力在治疗开始时使用纯音测听法进行评估,在它的结论,六个月后.纯音阈值与基线和CTCAE的差异-不良事件分级的通用术语标准与耳蜗剂量有关。
结果:该研究涉及75名患者。在超过40Gy的耳蜗剂量水平下,观察到显著的SNHL(>10dB损耗)。绝对PTA阈值在任何频率下从基线到完成都没有统计学差异。对于4000和8000Hz,从基线到随访,绝对PTA阈值不同,但仅在8000Hz随访6个月后差异有统计学意义.治疗后,64%的患者有I级CTCAE评分,16%和12%,分别,有渗出性中耳炎和咽鼓管功能障碍。
结论:接受头颈部辐射的患者可能会损害内耳。辐射诱导的SNHL通常在常规临床实践中没有报道,因为它具有长期性质。在具有高风险部位的头颈部肿瘤组中,近90%的SNHL患者受到影响.因此,减少这些患者人群的耳蜗剂量至关重要。需要更多的调查来区分耳蜗和后耳蜗类型的感觉神经性听力损失。
OBJECTIVE: To study effects of chemoradiation therapy on hearing in patients with malignancy of head and neck.
METHODS: Patients receiving drugs other than cisplatin as well as those with any otology-related pathology or abnormalities were excluded from the study. Patients with primary biopsy-proven malignancy of the Nasopharynx, Oropharynx, Paranasal Sinuses, Oral Cavity, and Parotid with chemoradiation by cisplatin and different radiation modalities were all eligible. Areas of interest and OARs are indicated on CT images. All patients\' hearing was assessed using pure tone audiometry at the beginning of treatment, at its conclusion, and six months later. Variations in pure tone thresholds from baseline and CTCAE - Common Terminology Criteria for Adverse Events grading are related to cochlear dose.
RESULTS: The study involves 75 patients. At cochlear dosage levels of more than 40 Gy, significant
SNHL (>10 dB loss) is seen. Absolute PTA threshold values do not statistically differ from baseline to completion at any frequency. For 4000 and 8000 Hz, the absolute PTA threshold values differed from baseline to follow-up, but only for 8000 Hz was the difference statistically significant after six months of follow-up. Following treatment, 64% of patients had grade I CTCAE scoring and 16% and 12%, respectively, had otitis media with effusion and Eustachian tube dysfunction.
CONCLUSIONS: The inner ear may be harmed in patients receiving radiation to the head and neck. Radiation-induced
SNHL typically goes unreported in routine clinical practise because of its long-term nature. In the group of head and neck tumours with high-risk locations, nearly 90% of patients with
SNHL were affected. Therefore, it\'s critical to reduce cochlear dosage in these patient populations. More investigation is needed to distinguish between cochlear and retro-cochlear types of sensorineural hearing loss.