Mechanism and Protection of Radiotherapy Induced Sensorineural Hearing Loss for Head and Neck Cancer.

Abstract

PURPOSE:

Radiotherapy-induced sensorineural hearing loss (RISNHL) is a common adverse effect in patients with head and neck cancer. Given that there are few studies on the pathogenesis of RISNHL at present, we summarized the possible pathogenesis of RISNHL and possible protective measures found at present by referring to relevant literatures.

METHODS:

We performed a comprehensive literature search in the PubMed database, using keywords "sensorineural hearing loss," "radiotherapy," and "cancer," among others. The literature was examined for the possible mechanism and preventive measures of sensorineural hearing loss induced by radiotherapy.

RESULTS:

We found that the incidence of RISNHL was closely related to the damage directly caused by ionizing radiation and the radiation-induced bystander effect. It also depends on the dose of radiation and the timing of chemotherapy. Studies confirmed that RISNHL is mainly involved in post-RT inflammatory response and changes in reactive oxygen species, mitogen-activated protein kinase, and p53 signaling pathways, leading to specific manners of cell death. We expect to reduce the incidence of hearing loss through advanced radiotherapy techniques, dose limitation of organs at risk, application of cell signaling inhibitors, use of antioxidants, induction of cochlear hair cell regeneration, and cochlear implantation.

CONCLUSION:

RISNHL is associated with radiation damage to DNA, oxidative stress, and inflammation of cochlear cells, stria vascularis endothelial cells, vascular endothelial cells, spiral ganglion neurons, and other supporting cells. At present, the occurrence mechanism of RISNHL has not been clearly illustrated, and further studies are needed to better understand the underlying mechanism, which is crucial to promote the formulation of better strategies and prevent the occurrence of RISNHL.

• Authors: Wenxia Shi, Xue Hou, Xueying Bao, Wei Hou, Xuehua Jiang, Lixin Ma, Xin Jiang, Lihua Dong
• Journal: BioMed research international (Biomed Res Int) Vol. 2021 Pg. 3548706 ( 2021) ISSN: 2314-6141 [Electronic] United States
• PMID: 34970625 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2021 Wenxia Shi et al.

Topics

• Animals
• Head and Neck Neoplasms (radiotherapy)
• Hearing Loss, Sensorineural (etiology)
• Humans
• Radiation Oncology (methods)
• Radiotherapy Dosage