Low early ototoxicity rates for pediatric medulloblastoma patients treated with proton radiotherapy
<p>Abstract</p> <p>Background</p> <p>Hearing loss is common following chemoradiotherapy for children with medulloblastoma. Compared to photons, proton radiotherapy reduces radiation dose to the cochlea for these patients. Here we examine whether this dosimetric advantag...
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doaj-b1e69d82adf64e10ac379d3b66c5dfe62020-11-24T21:53:00ZengBMCRadiation Oncology1748-717X2011-06-01615810.1186/1748-717X-6-58Low early ototoxicity rates for pediatric medulloblastoma patients treated with proton radiotherapyGidley Paul WWoo Shiao YMcAleer Mary FGrosshans David RPhilip Jimmy JChintagumpala MuraliMoeller Benjamin JVats Tribhawan SMahajan Anita<p>Abstract</p> <p>Background</p> <p>Hearing loss is common following chemoradiotherapy for children with medulloblastoma. Compared to photons, proton radiotherapy reduces radiation dose to the cochlea for these patients. Here we examine whether this dosimetric advantage leads to a clinical benefit in audiometric outcomes.</p> <p>Methods</p> <p>From 2006-2009, 23 children treated with proton radiotherapy for medulloblastoma were enrolled on a prospective observational study, through which they underwent pre- and 1 year post-radiotherapy pure-tone audiometric testing. Ears with moderate to severe hearing loss prior to therapy were censored, leaving 35 ears in 19 patients available for analysis.</p> <p>Results</p> <p>The predicted mean cochlear radiation dose was 30 <sup>60</sup>Co-Gy Equivalents (range 19-43), and the mean cumulative cisplatin dose was 303 mg/m<sup>2 </sup>(range 298-330). Hearing sensitivity significantly declined following radiotherapy across all frequencies analyzed (<it>P </it>< 0.05). There was partial sparing of mean post-radiation hearing thresholds at low-to-midrange frequencies and, consequently, the rate of high-grade (grade 3 or 4) ototoxicity at 1 year was favorable (5%). Ototoxicity did not correlate with predicted dose to the auditory apparatus for proton-treated patients, potentially reflecting a lower-limit threshold for radiation effect on the cochlea.</p> <p>Conclusions</p> <p>Rates of high-grade early post-radiation ototoxicity following proton radiotherapy for pediatric medulloblastoma are low. Preservation of hearing in the audible speech range, as observed here, may improve both quality of life and cognitive functioning for these patients.</p> http://www.ro-journal.com/content/6/1/58Protonradiotherapypediatricmedulloblastomaototoxicity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gidley Paul W Woo Shiao Y McAleer Mary F Grosshans David R Philip Jimmy J Chintagumpala Murali Moeller Benjamin J Vats Tribhawan S Mahajan Anita |
spellingShingle |
Gidley Paul W Woo Shiao Y McAleer Mary F Grosshans David R Philip Jimmy J Chintagumpala Murali Moeller Benjamin J Vats Tribhawan S Mahajan Anita Low early ototoxicity rates for pediatric medulloblastoma patients treated with proton radiotherapy Radiation Oncology Proton radiotherapy pediatric medulloblastoma ototoxicity |
author_facet |
Gidley Paul W Woo Shiao Y McAleer Mary F Grosshans David R Philip Jimmy J Chintagumpala Murali Moeller Benjamin J Vats Tribhawan S Mahajan Anita |
author_sort |
Gidley Paul W |
title |
Low early ototoxicity rates for pediatric medulloblastoma patients treated with proton radiotherapy |
title_short |
Low early ototoxicity rates for pediatric medulloblastoma patients treated with proton radiotherapy |
title_full |
Low early ototoxicity rates for pediatric medulloblastoma patients treated with proton radiotherapy |
title_fullStr |
Low early ototoxicity rates for pediatric medulloblastoma patients treated with proton radiotherapy |
title_full_unstemmed |
Low early ototoxicity rates for pediatric medulloblastoma patients treated with proton radiotherapy |
title_sort |
low early ototoxicity rates for pediatric medulloblastoma patients treated with proton radiotherapy |
publisher |
BMC |
series |
Radiation Oncology |
issn |
1748-717X |
publishDate |
2011-06-01 |
description |
<p>Abstract</p> <p>Background</p> <p>Hearing loss is common following chemoradiotherapy for children with medulloblastoma. Compared to photons, proton radiotherapy reduces radiation dose to the cochlea for these patients. Here we examine whether this dosimetric advantage leads to a clinical benefit in audiometric outcomes.</p> <p>Methods</p> <p>From 2006-2009, 23 children treated with proton radiotherapy for medulloblastoma were enrolled on a prospective observational study, through which they underwent pre- and 1 year post-radiotherapy pure-tone audiometric testing. Ears with moderate to severe hearing loss prior to therapy were censored, leaving 35 ears in 19 patients available for analysis.</p> <p>Results</p> <p>The predicted mean cochlear radiation dose was 30 <sup>60</sup>Co-Gy Equivalents (range 19-43), and the mean cumulative cisplatin dose was 303 mg/m<sup>2 </sup>(range 298-330). Hearing sensitivity significantly declined following radiotherapy across all frequencies analyzed (<it>P </it>< 0.05). There was partial sparing of mean post-radiation hearing thresholds at low-to-midrange frequencies and, consequently, the rate of high-grade (grade 3 or 4) ototoxicity at 1 year was favorable (5%). Ototoxicity did not correlate with predicted dose to the auditory apparatus for proton-treated patients, potentially reflecting a lower-limit threshold for radiation effect on the cochlea.</p> <p>Conclusions</p> <p>Rates of high-grade early post-radiation ototoxicity following proton radiotherapy for pediatric medulloblastoma are low. Preservation of hearing in the audible speech range, as observed here, may improve both quality of life and cognitive functioning for these patients.</p> |
topic |
Proton radiotherapy pediatric medulloblastoma ototoxicity |
url |
http://www.ro-journal.com/content/6/1/58 |
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