A systematic review showed that it is impossible to draw unambiguous conclusions about the incidence of (C)RT-induced ototoxicity, since different definitions of ototoxicity are used in the literature. Existing standards to score hearing impairment are available, but not consistently used. By developing a new grading system we facilitate a nuanced system, that may be used to assess the impact of hearing loss in specific situations in daily life. Furthermore, we developed a model to predict the treatment-induced hearing loss per individual. Based on pre-treatment hearing levels, radiation dose, and cisplatin dose, the model predicts the post-treatment hearing level at PTA 1-2-4 kHz. This model is a step towards improving counseling of patients.
In a long-term follow-up study we found significant CRT-induced hearing loss at long-term. Patients treated with CRT intra-arterial showed significantly less hearing loss at both short-term and long-term post-treatment measurements compared to patients treated with CRT intravenous. Another follow-up study showed that patients treated with IMRT suffer from modest treatment-induced hearing loss, provided that the radiation dose to the cochlea is limited.
In a study regarding hearing loss due to radiotherapy for head and neck rhabdomysarcoma in children, we concluded that 19% developed clinically relevant hearing loss at speech frequencies. Less hearing loss was seen after AMORE-based treatment compared to EBRT-based treatment.
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