Hearing Loss in Patients Who Received Cranial Radiation Therapy for Childhood Cancer

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Johnnie K BassThomas E Merchant

Abstract

Patients treated with cranial radiation therapy (RT) are at risk for sensorineural hearing loss (SNHL). Although SNHL is often characterized as a delayed consequence of anticancer therapy, longitudinal reports of SNHL in childhood cancer survivors treated with contemporary RT are limited. We report the incidence, onset, severity, and long-term trajectory of SNHL among children receiving RT. Potential risk factors for SNHL were also identified. Serial audiologic testing was conducted on 235 pediatric patients who were treated with conformal or intensity-modulated RT as part of an institutional phase II trial for localized primary brain tumors, including craniopharyngioma, ependymoma, and juvenile pilocytic astrocytoma. All but one patient had measurable cochlear radiation dose (CRD) greater than 0 Gy. The median follow-up from RT initiation to latest audiogram was 9 years with a median of 11 post-RT audiograms per patient. Audiograms were classified by the Chang Ototoxicity Grading Scale. Progression was defined by an increase in Chang grade from SNHL onset to the most recent evaluation. At last evaluation, SNHL was prevalent in 14% of patients: 2.1% had mild and 11.9% had significant SNHL requiring hearing aids. Median time fro...Continue Reading

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Citations

Jul 25, 2017·International Journal of Audiology·Beth Brooks, Kristin Knight
Dec 23, 2017·Pediatric Blood & Cancer·Jennifer L HarmanVictoria W Willard
Aug 4, 2018·American Journal of Audiology·Johnnie K BassThomas E Merchant
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