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The relevance of ototoxicity induced by radiotherapy
BACKGROUND: The risk of ototoxicity, characterized by hearing impairment, tinnitus, or middle ear inflammation, is elevated in both child and adult cancer survivors who have undergone head-neck or brain radiation, or a combination of the two. To provide optimal care for these cancer survivors and mi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10239118/ https://www.ncbi.nlm.nih.gov/pubmed/37270526 http://dx.doi.org/10.1186/s13014-023-02268-7 |
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author | Huang, Yan Zhou, Hong An, Fenglan Zhao, Aimei Wu, Jian Wang, Meihua Luo, Judong |
author_facet | Huang, Yan Zhou, Hong An, Fenglan Zhao, Aimei Wu, Jian Wang, Meihua Luo, Judong |
author_sort | Huang, Yan |
collection | PubMed |
description | BACKGROUND: The risk of ototoxicity, characterized by hearing impairment, tinnitus, or middle ear inflammation, is elevated in both child and adult cancer survivors who have undergone head-neck or brain radiation, or a combination of the two. To provide optimal care for these cancer survivors and minimize subsequent complications, it is crucial to comprehend the relationship between radiotherapy and ototoxicity. METHODS: A comprehensive search of databases, including the Cochrane Library, PubMed, Embase, and Web of Science, was conducted from the inception of the knowledge base up until January 2023. The metafor-package was employed to compare ototoxicity rates in individuals receiving radiotherapy. Two independent assessors extracted data and analyzed targets using a random-effects model. RESULTS: Out of the 28 randomized controlled trials (RCTs) included in the analysis, 25 were prospective RCTs. Subgroup analysis revealed that mean cochlear radiation dose, primary tumor location, radiotherapy modality, and patient age significantly influenced total hearing impairment. Intensity-modulated radiotherapy was associated with less ototoxicity than 2D conventional radiotherapy (OR, 0.53; 95% CI, 0.47–0.60; P = 0.73; I(2) = 0%). Stereotactic radiotherapy appeared to be a superior option for hearing preservation compared to radiosurgery (OR, 1.44; 95% CI, 1.00–2.07; P = 0.69; I(2) = 0%). Children demonstrated a higher risk of hearing impairment than adults. More than 50% of patients with vestibular neuroadenoma experienced hearing impairment following radiation therapy. A strong association was observed between the average cochlear radiation dose and hearing impairment. Increased cochlear radiation doses may result in a heightened risk of hearing impairment. CONCLUSION: Several risk factors for radiation-induced hearing impairment were identified in this study. High cochlear radiation doses were found to exacerbate the risk of hearing impairment resulting from radiation therapy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13014-023-02268-7. |
format | Online Article Text |
id | pubmed-10239118 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102391182023-06-04 The relevance of ototoxicity induced by radiotherapy Huang, Yan Zhou, Hong An, Fenglan Zhao, Aimei Wu, Jian Wang, Meihua Luo, Judong Radiat Oncol Research BACKGROUND: The risk of ototoxicity, characterized by hearing impairment, tinnitus, or middle ear inflammation, is elevated in both child and adult cancer survivors who have undergone head-neck or brain radiation, or a combination of the two. To provide optimal care for these cancer survivors and minimize subsequent complications, it is crucial to comprehend the relationship between radiotherapy and ototoxicity. METHODS: A comprehensive search of databases, including the Cochrane Library, PubMed, Embase, and Web of Science, was conducted from the inception of the knowledge base up until January 2023. The metafor-package was employed to compare ototoxicity rates in individuals receiving radiotherapy. Two independent assessors extracted data and analyzed targets using a random-effects model. RESULTS: Out of the 28 randomized controlled trials (RCTs) included in the analysis, 25 were prospective RCTs. Subgroup analysis revealed that mean cochlear radiation dose, primary tumor location, radiotherapy modality, and patient age significantly influenced total hearing impairment. Intensity-modulated radiotherapy was associated with less ototoxicity than 2D conventional radiotherapy (OR, 0.53; 95% CI, 0.47–0.60; P = 0.73; I(2) = 0%). Stereotactic radiotherapy appeared to be a superior option for hearing preservation compared to radiosurgery (OR, 1.44; 95% CI, 1.00–2.07; P = 0.69; I(2) = 0%). Children demonstrated a higher risk of hearing impairment than adults. More than 50% of patients with vestibular neuroadenoma experienced hearing impairment following radiation therapy. A strong association was observed between the average cochlear radiation dose and hearing impairment. Increased cochlear radiation doses may result in a heightened risk of hearing impairment. CONCLUSION: Several risk factors for radiation-induced hearing impairment were identified in this study. High cochlear radiation doses were found to exacerbate the risk of hearing impairment resulting from radiation therapy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13014-023-02268-7. BioMed Central 2023-06-03 /pmc/articles/PMC10239118/ /pubmed/37270526 http://dx.doi.org/10.1186/s13014-023-02268-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Huang, Yan Zhou, Hong An, Fenglan Zhao, Aimei Wu, Jian Wang, Meihua Luo, Judong The relevance of ototoxicity induced by radiotherapy |
title | The relevance of ototoxicity induced by radiotherapy |
title_full | The relevance of ototoxicity induced by radiotherapy |
title_fullStr | The relevance of ototoxicity induced by radiotherapy |
title_full_unstemmed | The relevance of ototoxicity induced by radiotherapy |
title_short | The relevance of ototoxicity induced by radiotherapy |
title_sort | relevance of ototoxicity induced by radiotherapy |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10239118/ https://www.ncbi.nlm.nih.gov/pubmed/37270526 http://dx.doi.org/10.1186/s13014-023-02268-7 |
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