Hearing Loss and Middle Ear Effusion in Nasopharyngeal Carcinoma Following Radiotherapy: Dose-Response Relationship...

Area of Science:

• Oncology
• Radiation Oncology
• Audiology

Background:

• Radiotherapy is a primary treatment for nasopharyngeal carcinoma (NPC).
• Radiation exposure to the cochlea and middle ear can lead to hearing impairment.
• Predicting and mitigating these complications is crucial for patient quality of life.

Purpose of the Study:

• To develop a multivariable normal tissue complication probability (NTCP) model for predicting hearing loss risk in NPC patients.
• To identify clinical and dosimetric factors associated with hearing impairment.
• To aid in radiotherapy treatment planning to reduce auditory complications.

Main Methods:

• Retrospective review of 229 nasopharyngeal cancer patients.
• Analysis of audiometry, middle ear effusion (MEE), clinical data, and radiation dosimetry.
• Multivariate logistic regression to formulate the NTCP model.

Main Results:

• Age >50, high primary tumor stage (T3-4), and cochlear dose >43 Gy were significant risk factors for sensorineural hearing loss.
• The NTCP model for hearing loss (age, cochlear dose) showed an AUC of 0.644.
• Locally advanced disease and cochlear dose >44 Gy were risk factors for MEE.

Conclusions:

• Age, advanced T stage, and cochlear dose are significantly associated with sensorineural hearing loss and MEE in NPC patients.
• The developed NTCP model can predict the risk of hearing complications.
• This predictive tool can assist in optimizing radiotherapy planning to minimize hearing loss.