- 期刊
鼻咽癌經不同模式放射線治療後感音性聽損之臨床分析
Clinical Analysis of Sensorineural Hearing Loss in Nasopharyngeal Cancer Patients after Different Radiotherapy Modalities
摘要
BACKGROUND: Radiotherapy continues to be the main method of treatment for nasopharyngeal carcinoma (NPC). After undergoing radiotherapy, the sensorineural hearing threshold values of patients with NPC increases with time; this is a common clinical symptom. This study analyzes the levels of sensorineural hearing loss in patients with NPC who were treated with different radiotherapeutic modalities. METHODS: This study retrospectively collected data on hearing tests of patients with NPC who had head and neck radiotherapy between January 1998 and July 2006. The patients were divided into two groups: traditional radiotherapy (three-dimensional conformal radiotherapy [3D-CRT]) and intensity-modulated radiotherapy (IMRT). The changes in the patients' sensorineural hearing loss after treatment were analyzed annually. The IMRT group was further divided into two groups: with chemotherapy and without chemotherapy. The changes in hearing loss after treatment were analyzed. RESULTS: A total of 61 patients were recruited for this study. The average age was 47.7 years, and the male to female ratio was 2:1. A paired-t test analysis method was used. No statistical difference existed in the annual sensorineural hearing loss threshold values for left and right ears between the two patient groups between the first and fifth years following radiotherapy. In comparing the 3D-CRT and IMRT groups, no statistical differences existed in the reduction of sensorineural hearing threshold values between the first and second years after radiotherapy (p=0.629 and 0.438, respectively). However, the reduction in the sensorineural hearing threshold values of the IMRT group in the third, fourth, and fifth years were significantly greater than the 3D-CRT group. There were no statistical differences between the sensorineural hearing threshold values of the IMRT sub-groups (with and without chemotherapy) in the first, second, or third years post-radiotherapy. CONCLUSION: Compared with traditional radiotherapy, the dosage distribution of IMRT within the treatment area contains hot spots, which means higher radiation in the target area. Leading to more damage to other tissues. A higher dosage of radiation to the auditory nerve and cochlea could not be avoided and led to obvious sensorineural hearing loss.
並列摘要
BACKGROUND: Radiotherapy continues to be the main method of treatment for nasopharyngeal carcinoma (NPC). After undergoing radiotherapy, the sensorineural hearing threshold values of patients with NPC increases with time; this is a common clinical symptom. This study analyzes the levels of sensorineural hearing loss in patients with NPC who were treated with different radiotherapeutic modalities. METHODS: This study retrospectively collected data on hearing tests of patients with NPC who had head and neck radiotherapy between January 1998 and July 2006. The patients were divided into two groups: traditional radiotherapy (three-dimensional conformal radiotherapy [3D-CRT]) and intensity-modulated radiotherapy (IMRT). The changes in the patients' sensorineural hearing loss after treatment were analyzed annually. The IMRT group was further divided into two groups: with chemotherapy and without chemotherapy. The changes in hearing loss after treatment were analyzed. RESULTS: A total of 61 patients were recruited for this study. The average age was 47.7 years, and the male to female ratio was 2:1. A paired-t test analysis method was used. No statistical difference existed in the annual sensorineural hearing loss threshold values for left and right ears between the two patient groups between the first and fifth years following radiotherapy. In comparing the 3D-CRT and IMRT groups, no statistical differences existed in the reduction of sensorineural hearing threshold values between the first and second years after radiotherapy (p=0.629 and 0.438, respectively). However, the reduction in the sensorineural hearing threshold values of the IMRT group in the third, fourth, and fifth years were significantly greater than the 3D-CRT group. There were no statistical differences between the sensorineural hearing threshold values of the IMRT sub-groups (with and without chemotherapy) in the first, second, or third years post-radiotherapy. CONCLUSION: Compared with traditional radiotherapy, the dosage distribution of IMRT within the treatment area contains hot spots, which means higher radiation in the target area. Leading to more damage to other tissues. A higher dosage of radiation to the auditory nerve and cochlea could not be avoided and led to obvious sensorineural hearing loss.
延伸閱讀
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