51. Hearing loss due to concurrent daily low-dose cisplatin chemoradiation for locally advanced head and neck cancer
- Author
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Wouter A. Dreschler, Alfons J. M. Balm, Yvonne J.W. Simis, Jan H. Schornagel, Coen R.N. Rasch, Roxanna S. Verkaik, Charlotte L. Zuur, Other departments, Ear, Nose and Throat, APH - Amsterdam Public Health, Otolaryngology / Head & Neck Surgery, and CCA - Innovative therapy
- Subjects
Oncology ,Male ,medicine.medical_specialty ,Hearing loss ,Statistics, Nonparametric ,Ototoxicity ,Audiometry ,Risk Factors ,Internal medicine ,medicine ,otorhinolaryngologic diseases ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Hearing Loss ,Cisplatin ,medicine.diagnostic_test ,Radiotherapy ,business.industry ,Head and neck cancer ,Hematology ,Audiogram ,Middle Aged ,medicine.disease ,Head and neck squamous-cell carcinoma ,Combined Modality Therapy ,Head and Neck Neoplasms ,Concomitant ,Female ,medicine.symptom ,business ,medicine.drug - Abstract
Background and purpose: Cisplatin-based chemo-irradiation (CRT) is increasingly used for head and neck squamous cell carcinoma (HNSCC). We aimed to assess hearing deterioration due to low-dose cisplatin chemoradiation and to compare the observed hearing loss with hearing loss in our previously described high-dose cisplatin CRT cohort. Materials and methods: A prospective analysis of hearing thresholds at low and (ultra)-high frequencies obtained before and after treatment in 60 patients. Patients received low-dose cisplatin (6 mg/m(2), daily infusions, 20-25 days) with concomitant accelerated radiotherapy (70 Gy). Results: Audiometry up to 16 kHz was performed before therapy and 31 days (median) post-treatment. The total incidence of ototoxicity in CTCAEv3.0 was 31% in audiograms up to 8 kHz, and 5% of ears tested qualified for HAs due to treatment. The mean hearing loss at speech frequencies was 2.6 dB (SD 5.7) and 2.3 dB (SD 9.2) at PTA 1-2-4 kHz air-conduction and bone-conduction, respectively. The mean hearing loss at ultra-high frequencies (PTA AC 8-10-12.5 kHz) was 9.0 dB (SD 8.1). Low-dose cisplatin CRT caused less acute hearing loss (CTCAE 31%), compared to high-dose cisplatin CRT (CTCAE 78%). Conclusions: Low-dose cisplatin chemo-irradiation for HNSCC is a relatively safe treatment protocol with respect to ototoxicity. Crown copyright (C) 2008 Published by Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 89 (2008) 38-43
- Published
- 2008