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08.09.2017 | Original Article

Impact of radiation technique, radiation fraction dose, and total cisplatin dose on hearing

Retrospective analysis of 29 medulloblastoma patients

verfasst von: Sergiu Scobioala, MD, Ross Parfitt, Peter Matulat, Christopher Kittel, Fatemeh Ebrahimi, Heidi Wolters, Ph.D, Antoinette am Zehnhoff-Dinnesen, M.D. Ph.D., Hans Theodor Eich, M.D. Ph.D.

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 11/2017

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Abstract

Purpose

To analyze the incidence and degree of sensorineural hearing loss (SNHL) resulting from different radiation techniques, fractionation dose, mean cochlear radiation dose (D_mean), and total cisplatin dose.

Material and methods

In all, 29 children with medulloblastoma (58 ears) with subclinical pretreatment hearing thresholds participated. Radiotherapy (RT) and cisplatin had been applied sequentially according to the HIT MED Guidance. Audiological outcomes up to the latest follow-up (median 2.6 years) were compared.

Results

Bilateral high-frequency SNHL was observed in 26 patients (90%). No significant differences were found in mean hearing threshold between left and right ears at any frequency. A significantly better audiological outcome (p < 0.05) was found after tomotherapy at the 6 kHz bone-conduction threshold (BCT) and left-sided 8 kHz air-conduction threshold (ACT) than after a combined radiotherapy technique (CT). Fraction dose was not found to have any impact on the incidence, degree, and time-to-onset of SNHL. Patients treated with CT had a greater risk of SNHL at high frequencies than tomotherapy patients even though D_mean was similar. Increase in severity of SNHL was seen when the total cisplatin dose reached above 210 mg/m², with the highest abnormal level found 8–12 months after RT regardless of radiation technique or fraction dose.

Conclusion

The cochlear radiation dose should be kept as low as possible in patients who receive simultaneous cisplatin-based chemotherapy. The risk of clinically relevant HL was shown when D_mean exceeds 45 Gy independent of radiation technique or radiation regime. Cisplatin ototoxicity was shown to have a dose-dependent effect on bilateral SNHL, which was more pronounced in higher frequencies.

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Titel: Impact of radiation technique, radiation fraction dose, and total cisplatin dose on hearing
Retrospective analysis of 29 medulloblastoma patients
verfasst von: Sergiu Scobioala, MD
Ross Parfitt
Peter Matulat
Christopher Kittel
Fatemeh Ebrahimi
Heidi Wolters, Ph.D
Antoinette am Zehnhoff-Dinnesen, M.D. Ph.D.
Hans Theodor Eich, M.D. Ph.D.
Publikationsdatum: 08.09.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 11/2017
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-017-1205-y

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Springer Medizin

Impact of radiation technique, radiation fraction dose, and total cisplatin dose on hearing

Retrospective analysis of 29 medulloblastoma patients

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Purpose

Material and methods

Results

Conclusion

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Conclusion

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