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The cochlear dose and the age at radiotherapy predict severe hearing loss after passive scattering proton therapy and cisplatin in children with medulloblastoma.
Abu-Arja, Mohammad H; Brown, Austin L; Su, Jack M; Okcu, M Fatih; Lindsay, Holly B; McGovern, Susan L; McAleer, Mary Frances; Grosshans, David R; Chintagumpala, Murali M; Paulino, Arnold C.
Afiliação
  • Abu-Arja MH; The Division of Hematology/Oncology, Department of Pediatrics, Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
  • Brown AL; The Division of Hematology/Oncology, Department of Pediatrics, Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
  • Su JM; The Division of Hematology/Oncology, Department of Pediatrics, Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
  • Okcu MF; The Division of Hematology/Oncology, Department of Pediatrics, Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
  • Lindsay HB; The Division of Hematology/Oncology, Department of Pediatrics, Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
  • McGovern SL; Center for Cancer and Blood Disorders, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Denver, Colorado.
  • McAleer MF; The Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Grosshans DR; The Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Chintagumpala MM; The Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Paulino AC; The Division of Hematology/Oncology, Department of Pediatrics, Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Neuro Oncol ; 2024 Jun 25.
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 2007-2022. Audiograms were graded using the International Society of Pediatric Oncology-Boston scale. Time to grade 3-4 HL was evaluated using Kaplan-Meier and multivariable Cox models to estimate hazard ratios (HR) and 95% confidence intervals (CI).

RESULTS:

Seventy-nine patients were treated with PSPT at a median age of 7.5 years (range3.1-21.1). The mean cochlear dose (Dmc) (±S.D.) was 31.5±8.5 Gy, and the cumulative cisplatin dose was 295±50 mg/m2. Fifty-nine patients (75%) received amifostine. Patients completed a median of 9 audiograms (range4-22) with a median audiogram follow-up of 49 months (range6-177). Twenty-seven patients (34%) had grade 3-4 HL. In adjusted Cox models, only higher Dmc (HR=1.12, 95% CI1.06-1.18) was associated with grade 3-4 HL. The predicted 3-year incidence of grade 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 (p=0.042). 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 (p=0.78).

CONCLUSIONS:

Children <7 years at radiotherapy with a Dmc ≥36 Gy are at higher risk for HL.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Neuro Oncol Assunto da revista: NEOPLASIAS / NEUROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Neuro Oncol Assunto da revista: NEOPLASIAS / NEUROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido