頭頸癌病患之聽力保健計畫

The Hearing Care of Head and Neck Cancer Patients With Cisplatin Treatment

張耿銘(Keng-Ming Chang) ； 林曜祥(Yaoh-Shiang Lin) ； 康柏皇(Bor-Hwang Kang) ； 李清池(Ching-Chih Lee) ； 吳德芳(Te-Fang Wu)

《台灣聽力語言學會雜誌》 45期 (2021/12) Pp. 1-8

https://doi.org/10.6143/JSLHAT.202112_(45).0001

摘要

化學藥物治療為常見頭頸癌病患的治療選項之一，其中順鉑（cisplatin）又占了絕大部分，而順鉑常見的副作用之一就是導致感音神經性聽力損失，常常在治療後帶來長期的生活功能影響。因此我們藉由早期偵測及介入的方式，在病人接受化學藥物治療的同時，每個月定期追蹤純音聽力檢查（pure tone audiometry），分別記錄左右耳的四個音頻：500、1000、2000、4000 Hz作為比較，並參考常見藥物副作用標準Common Terminology Criteria for Adverse Events（CTCAE），當出現問題時立即通知該負責醫師，給予適當的處置調整。本研究從2017～2019年的收案統計，出現聽力損傷的頭頸癌病患大約是10%，相較於文獻上比例少了許多，我們希望能藉此方式持續改善病患治療後的生活品質。

關鍵字

聽力損傷 ； 頭頸癌 ； 化學治療 ； 順鉑 ； 純音聽力檢查

並列摘要

It is well known that cisplatin is an ototoxicity agent and the patients with head and neck cancer can experience hearing loss and many other adverse effects of treatment. However, hearing loss can often be overlooked despite its obvious negative effect on patients' quality of life. Thus, we hope that early detection and early intervention could help reduce the risk of long-term hearing injury. We suggest regular survey of pure tone audiometry monthly during the chemotherapy course and the management may be adjusted if hearing loss detected as soon as possible.

並列關鍵字

Hearing loss ； Head and neck cancer ； Chemotherapy ； Cisplatin ； Pure tone audiometry

參考文獻

Paken, J., Govender, C. D., Pillay, M., & Sewram, V. (2016). Cisplatin-associated ototoxicity: A review for the health professional. Journal of Toxicology, 2016, 1809394. doi:10.1155/2016/1809394。

Chirtes, F., & Albu, S. (2014). Prevention and restoration of hearing loss associated with the use of cisplatin. BioMed Research International, 2014, 925485. doi:10.1155/2014/925485。

Nagy, J. L., Adelstein, D. J., Newman, C. W., Rybicki, L. A., Rice, T. W., & Lavertu, P. (1999). Cisplatin ototoxicity: The importance of baseline audiometry. American Journal of Clinical Oncology, 22, 305-308. doi:10.1097/00000421-199906000-00020。

Schuette, A., Lander, D. P., Kallogjeri, D., Collopy, C., Goddu, S., Wildes, T. M., ... Piccirillo, J. F. (2019). Predicting hearing loss after radiotherapy and cisplatin chemotherapy in patients with head and neck cancer. JAMA Otolaryngology—Head & Neck Surgery, 146, 106-112. doi:10.1001/jamaoto.2019.3550。