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Title: Ototoxicity after radiotherapy for head and neck tumors

Abstract

Purpose: To investigate the incidence of radiation-induced ototoxicity according to the total dose delivered to specific parts of the auditory system, fractionation, and chemotherapy. Methods and Materials: Records of 325 patients treated for primary extracranial head and neck tumors with curative intent who received radiotherapy between 1964 and 2000 (median follow-up, 5.4 years) were retrospectively reviewed. Reconstructions of the treatment plans were generated to estimate the doses received by components of the auditory system. Results: Radiotherapy-induced morbidity developed in 41.8% of patients (external ear, 33.2%; middle ear, 28.6%; and inner ear, 26.8%). Univariate/multivariate analyses indicate that total dose received by parts of the auditory system seem to be significant, though fractionation and chemoradiation may contribute to the incidence of ototoxicities. Sensorineural hearing loss (SNHL) was observed in 49 patients (15.1%). Univariate and multivariate analyses indicated that age (p = 0.0177 and p = 0.005) and dose to cochlea (p < 0.0001 and p < 0.0001) were significant, and chemoradiation (p = 0.0281 and p = 0.006) may increase the incidence of SNHL. Five-year and 10-year actuarial risk of clinically overt SNHL increased to 37% (p > 0.0001) above doses of 60.5 Gy compared to 3% at doses below 60.5 Gy.more » For patients treated with adjuvant chemotherapy, clinically overt SNHL increased to 30% compared to 18% in the no-chemotherapy group at 10 years (p = 0.0281). Conclusion: Radiotherapy toxicity was observed in all parts of the auditory system with median doses for incidence varying between 60 Gy to 66 Gy. Total dose to organ seems to be a significant factor though fractionation and chemo-radiation may contribute to ototoxicities.« less

Authors:
 [1];  [2];  [1];  [1];  [3]
  1. Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States)
  2. Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL (United States)
  3. Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States). E-mail: mendewil@shands.ufl.edu
Publication Date:
OSTI Identifier:
20944689
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2006.09.017; PII: S0360-3016(06)02996-8; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AUDITORY ORGANS; CARCINOMAS; CHEMOTHERAPY; FRACTIONATED IRRADIATION; HEAD; MULTIVARIATE ANALYSIS; NECK; PATIENTS; RADIATION DOSES; RADIOTHERAPY; TOXICITY

Citation Formats

Bhandare, Niranjan, Antonelli, Patrick J., Morris, Christopher G., Malayapa, Robert S., and Mendenhall, William M.. Ototoxicity after radiotherapy for head and neck tumors. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.09.017.
Bhandare, Niranjan, Antonelli, Patrick J., Morris, Christopher G., Malayapa, Robert S., & Mendenhall, William M.. Ototoxicity after radiotherapy for head and neck tumors. United States. doi:10.1016/j.ijrobp.2006.09.017.
Bhandare, Niranjan, Antonelli, Patrick J., Morris, Christopher G., Malayapa, Robert S., and Mendenhall, William M.. Thu . "Ototoxicity after radiotherapy for head and neck tumors". United States. doi:10.1016/j.ijrobp.2006.09.017.
@article{osti_20944689,
title = {Ototoxicity after radiotherapy for head and neck tumors},
author = {Bhandare, Niranjan and Antonelli, Patrick J. and Morris, Christopher G. and Malayapa, Robert S. and Mendenhall, William M.},
abstractNote = {Purpose: To investigate the incidence of radiation-induced ototoxicity according to the total dose delivered to specific parts of the auditory system, fractionation, and chemotherapy. Methods and Materials: Records of 325 patients treated for primary extracranial head and neck tumors with curative intent who received radiotherapy between 1964 and 2000 (median follow-up, 5.4 years) were retrospectively reviewed. Reconstructions of the treatment plans were generated to estimate the doses received by components of the auditory system. Results: Radiotherapy-induced morbidity developed in 41.8% of patients (external ear, 33.2%; middle ear, 28.6%; and inner ear, 26.8%). Univariate/multivariate analyses indicate that total dose received by parts of the auditory system seem to be significant, though fractionation and chemoradiation may contribute to the incidence of ototoxicities. Sensorineural hearing loss (SNHL) was observed in 49 patients (15.1%). Univariate and multivariate analyses indicated that age (p = 0.0177 and p = 0.005) and dose to cochlea (p < 0.0001 and p < 0.0001) were significant, and chemoradiation (p = 0.0281 and p = 0.006) may increase the incidence of SNHL. Five-year and 10-year actuarial risk of clinically overt SNHL increased to 37% (p > 0.0001) above doses of 60.5 Gy compared to 3% at doses below 60.5 Gy. For patients treated with adjuvant chemotherapy, clinically overt SNHL increased to 30% compared to 18% in the no-chemotherapy group at 10 years (p = 0.0281). Conclusion: Radiotherapy toxicity was observed in all parts of the auditory system with median doses for incidence varying between 60 Gy to 66 Gy. Total dose to organ seems to be a significant factor though fractionation and chemo-radiation may contribute to ototoxicities.},
doi = {10.1016/j.ijrobp.2006.09.017},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 67,
place = {United States},
year = {Thu Feb 01 00:00:00 EST 2007},
month = {Thu Feb 01 00:00:00 EST 2007}
}