Hearing Loss in Cancer Patients with Skull Base Tumors Undergoing Pencil Beam Scanning Proton Therapy: A Retrospective Cohort Study
To assess the incidence and severity of changes in hearing threshold in patients undergoing high-dose pencil-beam-scanning proton therapy (PBS-PT). This retrospective cohort study included fifty-one patients (median 50 years (range, 13–68)) treated with PBS-PT for skull base tumors. No chemotherapy...
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MDPI AG
2022-08-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/16/3853 |
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| author | Barbara Bachtiary Dorothe Veraguth Nicolaas Roos Flurin Pfiffner Dominic Leiser Alessia Pica Marc Walser Stefanie von Felten Damien C. Weber |
| author_facet | Barbara Bachtiary Dorothe Veraguth Nicolaas Roos Flurin Pfiffner Dominic Leiser Alessia Pica Marc Walser Stefanie von Felten Damien C. Weber |
| author_sort | Barbara Bachtiary |
| collection | DOAJ |
| description | To assess the incidence and severity of changes in hearing threshold in patients undergoing high-dose pencil-beam-scanning proton therapy (PBS-PT). This retrospective cohort study included fifty-one patients (median 50 years (range, 13–68)) treated with PBS-PT for skull base tumors. No chemotherapy was delivered. Pure tone averages (PTAs)were determined before (baseline) and after PBS-PT as the average hearing thresholds at frequencies of 0.5, 1, 2, and 4 kHz. Hearing changes were calculated as PTA differences between pre-and post-PBS-PT. A linear mixed-effects model was used to assess the relationship between the PTA at the follow-up and the baseline, the cochlea radiation dose intensity, the increased age, and the years after PBS-PT. Included patients were treated for chordoma (n = 24), chondrosarcoma (n = 9), head and neck tumors (n = 9), or meningioma (n = 3), with a mean tumor dose of 71.1 Gy (RBE) (range, 52.0–77.8), and a mean dose of 37 Gy (RBE) (range, 0.0–72.7) was delivered to the cochleas. The median time to the first follow-up was 11 months (IQR, 5.5–33.7). The PTA increased from a median of 15 dB (IQR 10.0–25) at the baseline to 23.8 (IQR 11.3–46.3) at the first follow-up. In the linear mixed-effect model, the baseline PTA (estimate 0.80, 95%CI 0.64 to 0.96, <i>p</i> ≤ 0.001), patient’s age (0.30, 0.03 to 0.57, <i>p</i> = 0.029), follow-up time (2.07, 0.92 to 3.23, <i>p</i> ≤ 0.001), and mean cochlear dose in Gy (RBE) (0.34, 0.21 to 0.46, <i>p</i> ≤ 0.001) were all significantly associated with an increase in PTA at follow-up. The applied cochlear dose and baseline PTA, age, and time after treatment were significantly associated with hearing loss after proton therapy. |
| first_indexed | 2024-03-09T13:43:11Z |
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| institution | Directory Open Access Journal |
| issn | 2072-6694 |
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| last_indexed | 2024-03-09T13:43:11Z |
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| spelling | doaj.art-57d1506b22324755abddd90d0009977f2023-11-30T21:03:28ZengMDPI AGCancers2072-66942022-08-011416385310.3390/cancers14163853Hearing Loss in Cancer Patients with Skull Base Tumors Undergoing Pencil Beam Scanning Proton Therapy: A Retrospective Cohort StudyBarbara Bachtiary0Dorothe Veraguth1Nicolaas Roos2Flurin Pfiffner3Dominic Leiser4Alessia Pica5Marc Walser6Stefanie von Felten7Damien C. Weber8Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, 5232 Villigen, SwitzerlandDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, University of Zurich, 8091 Zurich, SwitzerlandFaculty of Medicine, University of Zurich, 8006 Zurich, SwitzerlandDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, University of Zurich, 8091 Zurich, SwitzerlandCenter for Proton Therapy, Paul Scherrer Institute, ETH Domain, 5232 Villigen, SwitzerlandCenter for Proton Therapy, Paul Scherrer Institute, ETH Domain, 5232 Villigen, SwitzerlandCenter for Proton Therapy, Paul Scherrer Institute, ETH Domain, 5232 Villigen, SwitzerlandDepartment of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, SwitzerlandCenter for Proton Therapy, Paul Scherrer Institute, ETH Domain, 5232 Villigen, SwitzerlandTo assess the incidence and severity of changes in hearing threshold in patients undergoing high-dose pencil-beam-scanning proton therapy (PBS-PT). This retrospective cohort study included fifty-one patients (median 50 years (range, 13–68)) treated with PBS-PT for skull base tumors. No chemotherapy was delivered. Pure tone averages (PTAs)were determined before (baseline) and after PBS-PT as the average hearing thresholds at frequencies of 0.5, 1, 2, and 4 kHz. Hearing changes were calculated as PTA differences between pre-and post-PBS-PT. A linear mixed-effects model was used to assess the relationship between the PTA at the follow-up and the baseline, the cochlea radiation dose intensity, the increased age, and the years after PBS-PT. Included patients were treated for chordoma (n = 24), chondrosarcoma (n = 9), head and neck tumors (n = 9), or meningioma (n = 3), with a mean tumor dose of 71.1 Gy (RBE) (range, 52.0–77.8), and a mean dose of 37 Gy (RBE) (range, 0.0–72.7) was delivered to the cochleas. The median time to the first follow-up was 11 months (IQR, 5.5–33.7). The PTA increased from a median of 15 dB (IQR 10.0–25) at the baseline to 23.8 (IQR 11.3–46.3) at the first follow-up. In the linear mixed-effect model, the baseline PTA (estimate 0.80, 95%CI 0.64 to 0.96, <i>p</i> ≤ 0.001), patient’s age (0.30, 0.03 to 0.57, <i>p</i> = 0.029), follow-up time (2.07, 0.92 to 3.23, <i>p</i> ≤ 0.001), and mean cochlear dose in Gy (RBE) (0.34, 0.21 to 0.46, <i>p</i> ≤ 0.001) were all significantly associated with an increase in PTA at follow-up. The applied cochlear dose and baseline PTA, age, and time after treatment were significantly associated with hearing loss after proton therapy.https://www.mdpi.com/2072-6694/14/16/3853pencil-beam-scanning proton therapy (PBS-PT)skull base tumorshead and neck cancermeningiomapure tone average (PTA)hearing loss (HL) |
| spellingShingle | Barbara Bachtiary Dorothe Veraguth Nicolaas Roos Flurin Pfiffner Dominic Leiser Alessia Pica Marc Walser Stefanie von Felten Damien C. Weber Hearing Loss in Cancer Patients with Skull Base Tumors Undergoing Pencil Beam Scanning Proton Therapy: A Retrospective Cohort Study Cancers pencil-beam-scanning proton therapy (PBS-PT) skull base tumors head and neck cancer meningioma pure tone average (PTA) hearing loss (HL) |
| title | Hearing Loss in Cancer Patients with Skull Base Tumors Undergoing Pencil Beam Scanning Proton Therapy: A Retrospective Cohort Study |
| title_full | Hearing Loss in Cancer Patients with Skull Base Tumors Undergoing Pencil Beam Scanning Proton Therapy: A Retrospective Cohort Study |
| title_fullStr | Hearing Loss in Cancer Patients with Skull Base Tumors Undergoing Pencil Beam Scanning Proton Therapy: A Retrospective Cohort Study |
| title_full_unstemmed | Hearing Loss in Cancer Patients with Skull Base Tumors Undergoing Pencil Beam Scanning Proton Therapy: A Retrospective Cohort Study |
| title_short | Hearing Loss in Cancer Patients with Skull Base Tumors Undergoing Pencil Beam Scanning Proton Therapy: A Retrospective Cohort Study |
| title_sort | hearing loss in cancer patients with skull base tumors undergoing pencil beam scanning proton therapy a retrospective cohort study |
| topic | pencil-beam-scanning proton therapy (PBS-PT) skull base tumors head and neck cancer meningioma pure tone average (PTA) hearing loss (HL) |
| url | https://www.mdpi.com/2072-6694/14/16/3853 |
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