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Erschienen in: European Archives of Oto-Rhino-Laryngology 4/2019

22.01.2019 | Otology

Is intensity-modulated radiotherapy superior to conventional techniques to prevent late ear complications of nasopharyngeal cancer?

verfasst von: Ayca Ant, Ömer Yazici, Pinar Atabey, Ferit Ferhat Aslan, Arzubetul Duran, Samet Ozlugedik, Yusuf Kemal Kemaloglu

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 4/2019

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Abstract

Purpose

This study analyzed the late ear complications of radiotherapy for nasopharyngeal cancer (NPC) and compared the conventional and intensity-modulated radiotherapy (2D-RT and IMRT, respectively).

Methods

At 2–21 years after the end of NPC treatment, 104 ears of 52 patients were evaluated with the otoscopic examination, pure tone audiometry test, tympanometry, and subjective complaints by being blinded to the radiotherapy technique.

Results

There were no differences in terms of the pathology of the external, middle or inner ear, air and bone-conduction hearing thresholds, and the air–bone (A–B) gap at 500, 1000, 2000, and 4000 Hz, and tympanometry types between 2D-RT and IMRT groups (p > 0.05). There were positive correlations between the values of A500 and A1000 thresholds; gap 500, 4000, and mean cochlear RT dose (p < 0.05). There were positive correlations between the values of A500, A1000, and A4000 thresholds; gap 500, 1000, 2000, 4000, and maximum cochlear RT dose (p < 0.05).

Conclusion

IMRT was not found to be superior to 2D-RT to prevent RT-induced ear complications. The solution of the middle ear problems must be the goal of the strategies for complications treatment.
Literatur
1.
Zurück zum Zitat Jeyakumar A, Brickman TM, Jeyakumar A, Doerr T (2006) Review of nasopharyngeal carcinoma. ENT Ear Nose Throat J 85:168–173CrossRef Jeyakumar A, Brickman TM, Jeyakumar A, Doerr T (2006) Review of nasopharyngeal carcinoma. ENT Ear Nose Throat J 85:168–173CrossRef
2.
Zurück zum Zitat Low WKC, Rangabashyam M (2012) Ear-related issues in patients with nasopharyngeal carcinoma. In: Carcinogenesis, diagnosis, and molecular targeted treatment for nasopharyngeal carcinoma. InTech, Croatia, pp 155–178 Low WKC, Rangabashyam M (2012) Ear-related issues in patients with nasopharyngeal carcinoma. In: Carcinogenesis, diagnosis, and molecular targeted treatment for nasopharyngeal carcinoma. InTech, Croatia, pp 155–178
3.
Zurück zum Zitat Jereczek-Fossa BA, Zarowski A, Milani F, Orecchia R (2003) Radiotherapy-induced ear toxicity. Cancer Treat Rev 29(5):417–430CrossRefPubMed Jereczek-Fossa BA, Zarowski A, Milani F, Orecchia R (2003) Radiotherapy-induced ear toxicity. Cancer Treat Rev 29(5):417–430CrossRefPubMed
4.
Zurück zum Zitat Menzel HG (2014) International commission on radiation units and measurements. J ICRU 14(2):1–2 Menzel HG (2014) International commission on radiation units and measurements. J ICRU 14(2):1–2
5.
Zurück zum Zitat Sumitsawan Y, Chaiyasate S, Chitapanarux I, Anansuthiwara M, Roongrotwattanasiri K, Vaseenon V, Tooncam H (2009) Late complications of radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx 36(2):205–209CrossRefPubMed Sumitsawan Y, Chaiyasate S, Chitapanarux I, Anansuthiwara M, Roongrotwattanasiri K, Vaseenon V, Tooncam H (2009) Late complications of radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx 36(2):205–209CrossRefPubMed
6.
Zurück zum Zitat Bhandare N, Jackson A, Eisbruch A, Pan CC, Flickinger JC, Antonelli P, Mendenhall WM (2010) Radiation therapy and hearing loss. Int J Radiat Oncol Biol Phys 76(3):50–57CrossRef Bhandare N, Jackson A, Eisbruch A, Pan CC, Flickinger JC, Antonelli P, Mendenhall WM (2010) Radiation therapy and hearing loss. Int J Radiat Oncol Biol Phys 76(3):50–57CrossRef
7.
Zurück zum Zitat Fleury B, Lapeyre M (2010) Tolerance of normal tissues to radiation therapy: ear. Cancer Radiother 14(4–5):284–289CrossRefPubMed Fleury B, Lapeyre M (2010) Tolerance of normal tissues to radiation therapy: ear. Cancer Radiother 14(4–5):284–289CrossRefPubMed
8.
Zurück zum Zitat Wang X, Hu C, Eisbruch A (2011) Organ-sparing radiation therapy for head and neck cancer. Nat Rev Clin Oncol 8(11):639CrossRefPubMed Wang X, Hu C, Eisbruch A (2011) Organ-sparing radiation therapy for head and neck cancer. Nat Rev Clin Oncol 8(11):639CrossRefPubMed
9.
Zurück zum Zitat Pow EH, Kwong DL, McMillan AS, Wong MC, Sham JS, Leung LH, Leung WK (2006) Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Oncol Biol Phys 66(4):981–991CrossRefPubMed Pow EH, Kwong DL, McMillan AS, Wong MC, Sham JS, Leung LH, Leung WK (2006) Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Oncol Biol Phys 66(4):981–991CrossRefPubMed
11.
Zurück zum Zitat Chan SH, Ng WT, Kam KL, Lee MC, Choi CW, Yau TK et al (2009) Sensorineural hearing loss after treatment of nasopharyngeal carcinoma: a longitudinal analysis. Int J Radiat Oncol Biol Phys 73(5):1335–1342CrossRefPubMed Chan SH, Ng WT, Kam KL, Lee MC, Choi CW, Yau TK et al (2009) Sensorineural hearing loss after treatment of nasopharyngeal carcinoma: a longitudinal analysis. Int J Radiat Oncol Biol Phys 73(5):1335–1342CrossRefPubMed
12.
Zurück zum Zitat Li JJ, Guo YK, Tang QL, Li SS, Zhang XL, Wu PA, Yang XM (2010) Prospective study of sensorineural hearing loss following radiotherapy for nasopharyngeal carcinoma. J Laryngol Otol 124(1):32–36CrossRefPubMed Li JJ, Guo YK, Tang QL, Li SS, Zhang XL, Wu PA, Yang XM (2010) Prospective study of sensorineural hearing loss following radiotherapy for nasopharyngeal carcinoma. J Laryngol Otol 124(1):32–36CrossRefPubMed
13.
Zurück zum Zitat Wang LF, Kuo WR, Ho KY, Lee KW, Lin CS (2004) A long-term study on hearing status in patients with nasopharyngeal carcinoma after radiotherapy. Otol Neurotol 25(2):168–173CrossRefPubMed Wang LF, Kuo WR, Ho KY, Lee KW, Lin CS (2004) A long-term study on hearing status in patients with nasopharyngeal carcinoma after radiotherapy. Otol Neurotol 25(2):168–173CrossRefPubMed
14.
Zurück zum Zitat Wakisaka H, Yamada H, Motoyoshi K, Ugumori T, Takahashi H, Hyodo M (2011) Incidence of long-term ipsilateral and contralateral ototoxicity following radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx 38(1):95–100CrossRefPubMed Wakisaka H, Yamada H, Motoyoshi K, Ugumori T, Takahashi H, Hyodo M (2011) Incidence of long-term ipsilateral and contralateral ototoxicity following radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx 38(1):95–100CrossRefPubMed
15.
Zurück zum Zitat Hsin CH, Chen TH, Young YH, Liu WS (2010) Comparison of otologic complications between intensity-modulated and two-dimensional radiotherapies in nasopharyngeal carcinoma patients. Otolaryngol Head Neck Surg 143(5):662–668CrossRefPubMed Hsin CH, Chen TH, Young YH, Liu WS (2010) Comparison of otologic complications between intensity-modulated and two-dimensional radiotherapies in nasopharyngeal carcinoma patients. Otolaryngol Head Neck Surg 143(5):662–668CrossRefPubMed
16.
Zurück zum Zitat Zeng L, Tian YM, Sun XM, Chen CY, Han F, Xiao WW et al (2014) Late toxicities after intensity-modulated radiotherapy for nasopharyngeal carcinoma: patient and treatment-related risk factors. Br J Cancer 110(1):49CrossRefPubMed Zeng L, Tian YM, Sun XM, Chen CY, Han F, Xiao WW et al (2014) Late toxicities after intensity-modulated radiotherapy for nasopharyngeal carcinoma: patient and treatment-related risk factors. Br J Cancer 110(1):49CrossRefPubMed
17.
Zurück zum Zitat Liang KL, Su MC, Twu CW, Jiang RS, Lin JC, Shiao JY (2011) Long-term result of management of otitis media with effusion in patients with post-irradiated nasopharyngeal carcinoma. Eur Arch Otorhinolaryngol 268(2):213–217CrossRefPubMed Liang KL, Su MC, Twu CW, Jiang RS, Lin JC, Shiao JY (2011) Long-term result of management of otitis media with effusion in patients with post-irradiated nasopharyngeal carcinoma. Eur Arch Otorhinolaryngol 268(2):213–217CrossRefPubMed
18.
Zurück zum Zitat Yao JJ, Zhou GQ, Lin L, Zhang WJ, Peng YL, Chen L et al (2015) Dose-volume factors associated with ear disorders following intensity modulated radiotherapy in nasopharyngeal carcinoma. Sci Rep 5:13525CrossRefPubMedPubMedCentral Yao JJ, Zhou GQ, Lin L, Zhang WJ, Peng YL, Chen L et al (2015) Dose-volume factors associated with ear disorders following intensity modulated radiotherapy in nasopharyngeal carcinoma. Sci Rep 5:13525CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Lou PJ, Chen WP, Tai CC (1999) Delayed Irradiation effects on nasal epithelium in patients with nasopharyngeal carcinoma; an ultrastructural study. Ann Otol Rhinol Laryngol 108(5):474–480CrossRefPubMed Lou PJ, Chen WP, Tai CC (1999) Delayed Irradiation effects on nasal epithelium in patients with nasopharyngeal carcinoma; an ultrastructural study. Ann Otol Rhinol Laryngol 108(5):474–480CrossRefPubMed
20.
Zurück zum Zitat Zhou Y, Tang A, Li J, Chen P, Mao R (2003) The damaged types of eustachian tube function in the patients of nasopharyngeal carcinoma after radiotherapy. Lin Chuang Er Bi Yan Hou Ke Za Zhi 17(8):464–465PubMed Zhou Y, Tang A, Li J, Chen P, Mao R (2003) The damaged types of eustachian tube function in the patients of nasopharyngeal carcinoma after radiotherapy. Lin Chuang Er Bi Yan Hou Ke Za Zhi 17(8):464–465PubMed
21.
Zurück zum Zitat Ho WK, Wei WI, Kwong DL, Sham JS, Tai PT, Yuen AP, Au DK (1999) Long-term sensorineural hearing deficit following radiotherapy in patients suffering from nasopharyngeal carcinoma: a prospective study. Head Neck J Sci Spec Head Neck 21(6):547–553CrossRef Ho WK, Wei WI, Kwong DL, Sham JS, Tai PT, Yuen AP, Au DK (1999) Long-term sensorineural hearing deficit following radiotherapy in patients suffering from nasopharyngeal carcinoma: a prospective study. Head Neck J Sci Spec Head Neck 21(6):547–553CrossRef
22.
Zurück zum Zitat Kwong DL, Wei WI, Sham JS, Ho WK, Yuen PW, Chua DT et al (1996) Sensorineural hearing loss in patients treated for nasopharyngeal carcinoma: a prospective study of the effect of radiation and cisplatin treatment. Int J Rad Oncol Biol Phys 36(2):281–289CrossRef Kwong DL, Wei WI, Sham JS, Ho WK, Yuen PW, Chua DT et al (1996) Sensorineural hearing loss in patients treated for nasopharyngeal carcinoma: a prospective study of the effect of radiation and cisplatin treatment. Int J Rad Oncol Biol Phys 36(2):281–289CrossRef
23.
Zurück zum Zitat Raaijmakers E, Engelen AM (2002) Is sensorineural hearing loss a possible side effect of nasopharyngeal and parotid irradiation? A systematic review of the literature. Radiother Oncol 65(1):1–7CrossRefPubMed Raaijmakers E, Engelen AM (2002) Is sensorineural hearing loss a possible side effect of nasopharyngeal and parotid irradiation? A systematic review of the literature. Radiother Oncol 65(1):1–7CrossRefPubMed
24.
Zurück zum Zitat Bohne BA, Marks JE, Glasgow GP (1985) Delayed effects of ionizing radiation on the ear. Laryngoscope 95(7):818–828CrossRefPubMed Bohne BA, Marks JE, Glasgow GP (1985) Delayed effects of ionizing radiation on the ear. Laryngoscope 95(7):818–828CrossRefPubMed
25.
Zurück zum Zitat Low WK, Burgess R, Fong KW, Wang DY (2005) Effect of radiotherapy on retro-cochlear auditory pathways. Laryngoscope 115(10):1823–1826CrossRefPubMed Low WK, Burgess R, Fong KW, Wang DY (2005) Effect of radiotherapy on retro-cochlear auditory pathways. Laryngoscope 115(10):1823–1826CrossRefPubMed
26.
Zurück zum Zitat Mujica–Mota M, Waissbluth S, Daniel SJ (2013) Characteristics of radiation-induced sensorineural hearing loss in head and neck cancer: A systematic review. Head neck 35(11):1662–1668CrossRefPubMed Mujica–Mota M, Waissbluth S, Daniel SJ (2013) Characteristics of radiation-induced sensorineural hearing loss in head and neck cancer: A systematic review. Head neck 35(11):1662–1668CrossRefPubMed
27.
Zurück zum Zitat Low WK, Tan MG, Chua AW, Sun L, Wang DY (2009) 12th Yahya cohen memorial lecture—the cellular and molecular basis of radiation-induced sensori-neural hearing loss. Ann Acad Med Singap 38(1):91PubMed Low WK, Tan MG, Chua AW, Sun L, Wang DY (2009) 12th Yahya cohen memorial lecture—the cellular and molecular basis of radiation-induced sensori-neural hearing loss. Ann Acad Med Singap 38(1):91PubMed
28.
Zurück zum Zitat Bhandare N, Antonelli PJ, Morris CG, Malayapa RS, Mendenhall WM (2007) Ototoxicity after radiotherapy for head and neck tumors. Int J Radiat Oncol Biol Phys 67(2):469–479CrossRefPubMed Bhandare N, Antonelli PJ, Morris CG, Malayapa RS, Mendenhall WM (2007) Ototoxicity after radiotherapy for head and neck tumors. Int J Radiat Oncol Biol Phys 67(2):469–479CrossRefPubMed
29.
Zurück zum Zitat Low WK, Toh ST, Wee J, Fook-Chong SM, Wang DY (2006) Sensorineural hearing loss after radiotherapy and chemoradiotherapy: a single, blinded, randomized study. J Clin Oncol 24(12):1904–1909CrossRefPubMed Low WK, Toh ST, Wee J, Fook-Chong SM, Wang DY (2006) Sensorineural hearing loss after radiotherapy and chemoradiotherapy: a single, blinded, randomized study. J Clin Oncol 24(12):1904–1909CrossRefPubMed
30.
Zurück zum Zitat Liberman PHP, Schultz C, Gomez MVSG, Carvalho AL, Pellizzon ACA, Testa JR et al (2004) Auditory effects after organ preservation protocol for laryngeal/hypopharyngeal carcinomas. Arch Otolaryngol Head Neck Surg 130(11):1265–1268CrossRefPubMed Liberman PHP, Schultz C, Gomez MVSG, Carvalho AL, Pellizzon ACA, Testa JR et al (2004) Auditory effects after organ preservation protocol for laryngeal/hypopharyngeal carcinomas. Arch Otolaryngol Head Neck Surg 130(11):1265–1268CrossRefPubMed
31.
Zurück zum Zitat Zuur CL, Simis YJ, Lansdaal PE, Hart AA, Rasch CR, Schornagel JH et al (2007) Risk factors of ototoxicity after cisplatin-based chemo-irradiation in patients with locally advanced head-and-neck cancer: a multivariate analysis. Int J Radiat Oncol Biol Phys 68(5):1320–1325CrossRefPubMed Zuur CL, Simis YJ, Lansdaal PE, Hart AA, Rasch CR, Schornagel JH et al (2007) Risk factors of ototoxicity after cisplatin-based chemo-irradiation in patients with locally advanced head-and-neck cancer: a multivariate analysis. Int J Radiat Oncol Biol Phys 68(5):1320–1325CrossRefPubMed
Metadaten
Titel
Is intensity-modulated radiotherapy superior to conventional techniques to prevent late ear complications of nasopharyngeal cancer?
verfasst von
Ayca Ant
Ömer Yazici
Pinar Atabey
Ferit Ferhat Aslan
Arzubetul Duran
Samet Ozlugedik
Yusuf Kemal Kemaloglu
Publikationsdatum
22.01.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 4/2019
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05299-7

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