The cochlear dose and the age at radiotherapy predict severe hearing loss after passive scattering proton therapy and cisplatin in children with medulloblastoma.
Neuro Oncol
; 26(10): 1912-1920, 2024 Oct 03.
Article
em En
| MEDLINE
| ID: mdl-38916058
ABSTRACT
BACKGROUND:
Hearing loss (HL) is associated with worse neurocognitive outcomes among patients with medulloblastoma. We aimed to identify risk factors associated with severe HL and to evaluate the generalizability of a published HL calculator among patients treated with passive scattering proton therapy (PSPT) and cisplatin.METHODS:
We identified patients aged 3-21 years who were treated at our centers between 2007 and 2022. Audiograms were graded using the International Society of Pediatric Oncology (SIOP) Boston scale. Time to grades 3-4 HL was evaluated using Kaplan-Meier and multivariable Cox models to estimate hazard ratios and 95% confidence intervals (CI).RESULTS:
Seventy-nine patients were treated with PSPT at a median age of 7.5 years (range 3.1-21.1). The mean cochlear dose (Dmc) (±SD) was 31.5â ±â 8.5 Gy, and the cumulative cisplatin dose was 295â ±â 50 mg/m2. Fifty-nine patients (75%) received amifostine. Patients completed a median of 9 audiograms (range 4-22) with a median audiogram follow-up of 49 months (range 6-177). Twenty-seven patients (34%) had grades 3-4 HL. In adjusted Cox models, only higher Dmc (HRâ =â 1.12, 95% CI1.06-1.18) was associated with grades 3-4 HL. The predicted 3-year incidence of grades 3-4 HL was 40.0% (95% CI 21.3-66.3) and 66.7% (95% CI 35.4-93.7) for children with Dmc ≥36 Gy and age at radiotherapy ≥7 and <7 years, respectively (Pâ =â .042). It was 8.9% (95% CI 2.3-31.6) and 15.6% (95% CI 5.3-41.1) for children with Dmc <36 Gy and age at radiotherapy ≥7 and <7 years, respectively (Pâ =â .78).CONCLUSIONS:
Children <7 years at radiotherapy with a Dmc ≥36 Gy are at higher risk for HL.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Cerebelares
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Cisplatino
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Cóclea
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Terapia com Prótons
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Perda Auditiva
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Meduloblastoma
Limite:
Adolescent
/
Adult
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Child
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Child, preschool
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Female
/
Humans
/
Male
Idioma:
En
Revista:
Neuro Oncol
Assunto da revista:
NEOPLASIAS
/
NEUROLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos