Ototoxicity and cochlear sparing in children with medulloblastoma: Proton vs. photon radiotherapy.

Abstract

PURPOSE:

To compare ototoxicity rates between medulloblastoma patients treated with protons vs. photons.

MATERIALS AND METHODS:

The study included 84 children diagnosed with medulloblastoma treated with either passively scattered protons (n = 38) or photons (n = 46). Patients underwent maximal safe resection followed by craniospinal irradiation, posterior fossa and/or tumor bed boost and chemotherapy according to one of 3 multi-institutional trials. Median audiogram follow-up was 56 months for protons and 66 months for photons.

RESULTS:

Mean cochlear dose (Dmc) was lower in patients treated with protons for both standard (p < 0.0001) and high-risk disease (p < 0.001). Grade 3 and 4 ototoxicity was seen in 7 of 75 (9.3%) and 9 of 91 (9.9%) ears (Brock, p = 0.91), 13 of 75 (17.3%) and 19 of 91 (20.9%) ears (POG, p = 0.56), and 15 of 75 (20.0%) and 21 of 91 (23.1%) ears (SIOP Boston, p = 0.63) with protons and photons respectively.

CONCLUSIONS:

While cochlear doses were lower in the proton group, patients treated with either protons or photons had similar Grade 3 and 4 ototoxicity rates.

• Authors: Arnold C Paulino, Anita Mahajan, Rong Ye, David R Grosshans, M Fatih Okcu, Jack Su, Mary Frances McAleer, Susan McGovern, Victor A Mangona, Murali Chintagumpala
• Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (Radiother Oncol) Vol. 128 Issue 1 Pg. 128-132 (07 2018) ISSN: 1879-0887 [Electronic] Ireland
• PMID: 29373195 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Elsevier B.V. All rights reserved.

Topics

• Adolescent
• Audiometry, Pure-Tone
• Cerebellar Neoplasms (radiotherapy)
• Child
• Child, Preschool
• Cochlea (radiation effects)
• Female
• Hearing (radiation effects)
• Hearing Loss (prevention & control)
• Humans
• Male
• Medulloblastoma (radiotherapy)
• Organ Sparing Treatments (methods)
• Photons (adverse effects, therapeutic use)
• Proton Therapy (adverse effects)
• Radiation Dosage
• Radiation Tolerance
• Radiotherapy (adverse effects, methods)
• Radiotherapy Dosage