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Radiotherapy-Induced Otitis Media With Effusion in Nasopharyngeal Carcinoma: A Meta-Analysis
Nevin Yi Meng Chua1, Yong Hoe Chan1, Woei Shyang Loh2
1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
The Laryngoscope
|April 2, 2026
Summary
Radiotherapy significantly increases the risk of otitis media with effusion (OME) in nasopharyngeal carcinoma (NPC) patients. Risk varies by radiotherapy technique, aiding personalized patient care.
Area of Science:
- Otolaryngology
- Oncology
- Radiotherapy
Background:
- Nasopharyngeal carcinoma (NPC) is prevalent in Asia, posing a significant health burden.
- Post-radiotherapy otitis media with effusion (OME) is the most common otologic toxicity in NPC patients, affecting 32.4%.
Purpose of the Study:
- To conduct the first meta-analysis synthesizing post-radiotherapy OME risk in NPC patients.
- To provide technique-specific risk estimates for informed clinical decision-making and patient counseling.
Main Methods:
- Systematic literature search of PubMed, Embase, and Cochrane Library up to April 23, 2025.
- Inclusion of observational studies on OME development post-radiotherapy in NPC patients.
- Random-effects modeling with risk difference (RD) and Hartung-Knapp adjustment for bias and small-study effects.
Main Results:
- Eight studies with 10 cohorts (582 patients) were analyzed.
- Overall RD for OME post-radiotherapy in NPC patients was 0.08 (p=0.0078).
- Technique-specific risks: 2D-RT (0.18), 3D-CRT (0.18), IMRT (0.19). No significant association with chemotherapy or NPC stage.
Conclusions:
- Radiotherapy significantly elevates OME risk in NPC patients.
- Marked technique-specific variations in OME risk exist.
- Findings support personalized counseling and evidence-based surveillance protocols for OME in NPC patients.
