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

Journal Article · Wed Dec 01 00:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.09.031· OSTI ID:21491513

Lobo, Mark ^[1]; Teh, Bin S ^[2]; Okcu, M Fatih ^[3]; South, Michael; Butler, E Brian ^[4]; Su, Jack; Chintagumpala, Murali ^[3]

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1. Baylor College of Medicine, Houston, TX (United States)
2. Department of Radiation Oncology, Methodist Hospital and The Methodist Hospital Research Institute, Houston, TX (United States)
3. Department of Pediatrics, Division of Hematology/Oncology, Texas Children's Hospital, Houston, TX (United States)
4. Department of Radiation Oncology, Methodist Hospital and Methodist Hospital Research Institute, Houston, TX (United States)

Purpose: To report the incidence of Pediatric Oncology Group (POG) Grade 3 or 4 ototoxicity in a cohort of patients treated with craniospinal irradiation (CSI) followed by posterior fossa (PF) and/or tumor bed (TB) boost using intensity-modulated radiation therapy (IMRT). Methods and Materials: From 1998 to 2006, 44 patients with medulloblastoma were treated with CSI followed by IMRT to the PF and/or TB and cisplatin-based chemotherapy. Patients with standard-risk disease were treated with 18 to 23.4 Gy CSI followed by either a (1) PF boost to 36 Gy and TB boost to 54 to 55.8 Gy or (2) TB boost to 55.8 Gy. Patients with high-risk disease received 36 to 39.6 Gy CSI followed by a (1) PF boost to 54 to 55.8 Gy, (2) PF boost to 45 Gy and TB boost to 55.8 Gy, or (3) TB boost to 55.8 Gy. Median audiogram follow-up was 41 months (range, 11-92.4 months). Results: POG Grade Ototoxicity 0, 1, 2, 3. and 4 was found in 29, 32, 11, 13. and 3 ears. respectively, with POG Grade 3 or 4 accounting for 18.2% of cases. There was a statistically significant difference in mean radiation dose (D{sub mean}) cochlea according to degree of ototoxicity, with D{sub mean} cochlea increasing with severity of hearing loss (p = 0.027). Conclusions: Severe ototoxicity was seen in 18.2% of ears in children treated with IMRT boost and cisplatin-based chemotherapy. Increasing dose to the cochlea was associated with increasing severity of hearing loss.

• OSTI ID: 21491513
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 78, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2009.09.031; PII: S0360-3016(09)03273-8; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
AUDITORY ORGANS
CEREBRUM
CHEMOTHERAPY
CHILDREN
HEARINGS
NEOPLASMS
RADIATION DOSES
RADIATION INJURIES
RADIOTHERAPY
AGE GROUPS
ANIMALS
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BRAIN
CENTRAL NERVOUS SYSTEM
DISEASES
DOCUMENT TYPES
DOSES
INJURIES
MAMMALS
MAN
MEDICINE
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
PRIMATES
RADIATION EFFECTS
RADIOLOGY
SENSE ORGANS
THERAPY
VERTEBRATES