Hearing loss in patients with oral cavity tumours treated with radiation and chemoradiation

Raman RR, Sreekanth G

Pdf Page Numbers :- 80-85

Raghu Raman R^1,* and Sreekanth G²

¹Department of Radiation Oncology, MNJ Institute of Oncology & Regional Cancer Centre, Hyderabad, Telangana, India

²Department of ENT, Gandhi Medical College, Hyderabad, Telangana, India

*Corresponding author: Dr. R Raghu Raman, Associate Professor, MNJ Institute of Oncology & Regional Cancer Centre, Red Hills, Lakadikapul, Hyderabad-500004, Telangana, India. Email: raghuraman3008@gmail.com

Received 03 April 2018; Revised 29 May 2018; Accepted 11 June 2018; Published 19 June 2018

Citation: Raman RR, Sreekanth G. Hearing loss in patients with oral cavity tumours treated with radiation and chemoradiation. J Med Sci Res. 2018; 6(3): 80-85. DOI: http://dx.doi.org/10.17727/JMSR.2018/6-14

Copyright: © 2018 Raman RR et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Aim: To analyze and report the short term sensorineural hearing loss with radiation alone and chemoradiation in patients with oral cavity tumours (Ca tongue and Ca Buccal mucosa) treated with conventional radical radiotherapy and concurrent weekly cisplatin.

Materials and methods: 30 patients with oral cavity squamous cell carcinomas were subjected to 66Gy radiation as radical or adjuvant treatment. Early lesions were operated and received RT only. T3 & T4 lesions underwent chemoradiation with weekly concurrent cisplatin @ 40mg/m². Among the 16 tongue patients 6 were postoperative and among the 14 BM patients 6 were postoperative. The middle ear and cochlea were contoured and mean doses calculated in 60 ears. Pure tone audiometry was performed as baseline before treatment, at 90 days and 180 days.

Results: The doses received between the 2 groups and the hearing loss in dB was compared. There were no significant difference in doses in all the ears except the ipsilateral and contra lateral ear of the BM patients. The mean chemotherapy doses were similar in both arms (p=0.4085). The 90 days and 180s day mean hearing loss was significant in all the groups with RT alone and chemoRT. There was no difference in the HL in the ChemoRT group of tongue and BM at 90 days (p=0.1592) and 180 days (p=0.4153).

Discussion: The sensorineural hearing loss (SNHL) in patients who receive RT or chemoRT even at moderate doses is progressive, but is mostly mild or moderate.

Conclusions: Changing collimation may change doses to the auditory apparatus. HL was progressive in both tongue & BM groups. RT doses of 66GY ± cisplatin @ 40mg/m² leads to mild HR in 60% patients and moderate HR in 18.4%.

Keywords: Hearing loss; oral cavity tumours; radiation; chemoradiation