Assessment of hearing ability in patients after head and neck cancer radiotherapy

Document Type : Original Paper

Authors

1 Associate Professor in Medical Physics, Department of Medical Physics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Students Research Committee, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.

3 Students Research Committee, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Department of Radiation Oncology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

10.22038/ijmp.2024.78841.2395

Abstract

Introduction: The study assesses radiation-induced sensorineural hearing loss (SNHL) in head and neck cancer patients, highlighting the common occurrence of SNHL as a significant side effect of radiation therapy (RT) targeting the cochlea and acoustic pathways.

Material and Methods: The study included 34 patients (22 men, 12 women, mean age 40.13 ± 26.8 years) with head and neck cancers undergoing three-dimensional conformal radiation therapy (3D-CRT); 16 also had chemoradiotherapy (CRT). Pure-tone audiometry (PTA: 250-8000 Hz) was done before, immediately after, and three months post-RT for all patients. Hearing impairment was evaluated using the CTCAE 4.03 scoring system.

Results: According to the findings, 19% and 37% of ears experienced SNHL immediately post-RT and 3 months after RT, respectively. The mean cochlear dose was 25.48 ± 13.56 Gy. A significant correlation existed between the cochlear dose and SNHL incidence (P-value < 0.05). Regression analysis indicated the mean cochlear dose as a robust predictor of SNHL, particularly at 8000 Hz (β = 0.570, P-value = 0.0001). Highest SNHL incidence at 8000 Hz, 3 months post-RT. A significant difference in SNHL threshold was observed between men and women at the frequency of 1000 Hz (P-value = 0.024). There was a statistically significant difference in SNHL thresholds between patients who underwent CRT versus those treated with RT alone(P-value < 0.05).

Conclusion: RT commonly causes SNHL in head and neck cancer patients. Mean cochlear dose predicts SNHL, especially at higher frequencies.

Keywords

Main Subjects



Articles in Press, Accepted Manuscript
Available Online from 27 May 2024
  • Receive Date: 19 March 2024
  • Revise Date: 23 May 2024
  • Accept Date: 27 May 2024