Is intensity-modulated radiotherapy superior to conventional techniques to prevent late ear complications of nasopharyngeal cancer?

Eur Arch Otorhinolaryngol. 2019 Apr;276(4):977-984. doi: 10.1007/s00405-019-05299-7. Epub 2019 Jan 22.

Abstract

Purpose: This study analyzed the late ear complications of radiotherapy for nasopharyngeal cancer (NPC) and compared the conventional and intensity-modulated radiotherapy (2D-RT and IMRT, respectively).

Methods: At 2-21 years after the end of NPC treatment, 104 ears of 52 patients were evaluated with the otoscopic examination, pure tone audiometry test, tympanometry, and subjective complaints by being blinded to the radiotherapy technique.

Results: There were no differences in terms of the pathology of the external, middle or inner ear, air and bone-conduction hearing thresholds, and the air-bone (A-B) gap at 500, 1000, 2000, and 4000 Hz, and tympanometry types between 2D-RT and IMRT groups (p > 0.05). There were positive correlations between the values of A500 and A1000 thresholds; gap 500, 4000, and mean cochlear RT dose (p < 0.05). There were positive correlations between the values of A500, A1000, and A4000 thresholds; gap 500, 1000, 2000, 4000, and maximum cochlear RT dose (p < 0.05).

Conclusion: IMRT was not found to be superior to 2D-RT to prevent RT-induced ear complications. The solution of the middle ear problems must be the goal of the strategies for complications treatment.

Keywords: Cancer; Ear; Hearing; Intensity-modulated radiotherapy; Late complication; Nasopharynx; Radiotherapy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Chemoradiotherapy / adverse effects
  • Ear / pathology
  • Ear / radiation effects*
  • Female
  • Hearing / radiation effects*
  • Hearing Disorders / diagnosis
  • Hearing Disorders / etiology*
  • Hearing Disorders / prevention & control
  • Hearing Tests
  • Humans
  • Male
  • Middle Aged
  • Nasopharyngeal Neoplasms / radiotherapy*
  • Nasopharyngeal Neoplasms / therapy
  • Radiation Injuries / prevention & control*
  • Radiotherapy / adverse effects*
  • Radiotherapy / methods
  • Radiotherapy, Intensity-Modulated / adverse effects*