Short-term cohort study on sensorineural hearing changes in head and neck radiotherapy

Area of Science:

• Oncology
• Otorhinolaryngology
• Radiation Oncology

Background:

• Head and neck cancers often require radiation therapy, which can pose risks to hearing.
• Sensorineural hearing loss (SNHL) is a potential side effect of cancer treatments affecting the head and neck region.

Purpose of the Study:

• To investigate the incidence of SNHL in head and neck cancer patients undergoing radiotherapy.
• To examine the correlation between radiation dose to the cochlea and SNHL.
• To determine the relationship between SNHL and the frequency range of hearing loss.

Main Methods:

• Pure tone audiometry (250-12,000 Hz) was conducted on 29 patients with head and neck tumors treated with 3D conformal radiation therapy.
• Patients were followed up for 6 months post-treatment.
• Statistical analysis, including paired t-tests, was used to assess changes in hearing thresholds.

Main Results:

• A significant difference in mean air conduction thresholds was observed before and after radiotherapy (p < 0.001).
• SNHL was diagnosed in 51% of patients (CTCAE criteria).
• SNHL incidence rose to 77% in patients receiving concurrent cisplatin chemotherapy. Higher radiation doses (>5000 cGy) to the cochlea increased SNHL risk. Hearing loss was more pronounced at higher frequencies with chemoradiation.

Conclusions:

• Radiation and cisplatin are ototoxic and must be considered in head and neck cancer treatment planning.
• Increased cisplatin dosage, cochlear radiation dose, and follow-up intervals may worsen SNHL severity and frequency.
• Radiation-induced SNHL may differ in characteristics from chemoradiation-induced SNHL.