Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/37996 http://dx.doi.org/10.1186/1748-717X-9-158 |
Resumo: | Background: Ototoxicity is a known side effect of combined radiation therapy and cisplatin chemotherapy for the treatment of medulloblastoma. the delivery of an involved field boost by intensity modulated radiation therapy (IMRT) may reduce the dose to the inner ear when compared with conventional radiotherapy. the dose of cisplatin may also affect the risk of ototoxicity. A retrospective study was performed to evaluate the impact of involved field boost using IMRT and cisplatin dose on the rate of ototoxicity.Methods: Data from 41 medulloblastoma patients treated with IMRT were collected. Overall and disease-free survival rates were calculated by Kaplan-Meier method Hearing function was graded according to toxicity criteria of Pediatric Oncology Group (POG). Doses to inner ear and total cisplatin dose were correlated with hearing function by univariate and multivariate data analysis.Results: After a mean follow-up of 44 months (range: 14 to 72 months), 37 patients remained alive, with two recurrences, both in spine with CSF involvement, resulting in a disease free-survival and overall survival of 85.2% and 90.2%, respectively. Seven patients (17%) experienced POG Grade 3 or 4 toxicity. Cisplatin dose was a significant factor for hearing loss in univariate analysis (p < 0.03). in multivariate analysis, median dose to inner ear was significantly associated with hearing loss (p < 0.01). POG grade 3 and 4 toxicity were uncommon with median doses to the inner ear bellow 42 Gy (p < 0.05) and total cisplatin dose of less than 375 mg/m(2) (p < 0.01).Conclusions: IMRT leads to a low rate of severe ototoxicity. Median radiation dose to auditory apparatus should be kept below 42 Gy. Cisplatin doses should not exceed 375 mg/m(2). |
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Vieira, Wilson AlbieriWeltman, EduardoChen, Michael JenweiSilva, Nasjla Saba da [UNIFESP]Cappellano, Andrea Maria [UNIFESP]Pereira, Liliane Desgualdo [UNIFESP]Gonçalves, Maria Inês Rebelo [UNIFESP]Ferrigno, RobsonHanriot, Rodrigo MoraisNadalin, WladimirOdone Filho, VicentePetrilli, Antonio Sergio [UNIFESP]Hosp Israelita Albert Einstein HIAEUniversidade de São Paulo (USP)Universidade Federal de São Paulo (UNIFESP)2016-01-24T14:37:36Z2016-01-24T14:37:36Z2014-07-21Radiation Oncology. London: Biomed Central Ltd, v. 9, 6 p., 2014.1748-717Xhttp://repositorio.unifesp.br/handle/11600/37996http://dx.doi.org/10.1186/1748-717X-9-158WOS000339593300001.pdf10.1186/1748-717X-9-158WOS:000339593300001Background: Ototoxicity is a known side effect of combined radiation therapy and cisplatin chemotherapy for the treatment of medulloblastoma. the delivery of an involved field boost by intensity modulated radiation therapy (IMRT) may reduce the dose to the inner ear when compared with conventional radiotherapy. the dose of cisplatin may also affect the risk of ototoxicity. A retrospective study was performed to evaluate the impact of involved field boost using IMRT and cisplatin dose on the rate of ototoxicity.Methods: Data from 41 medulloblastoma patients treated with IMRT were collected. Overall and disease-free survival rates were calculated by Kaplan-Meier method Hearing function was graded according to toxicity criteria of Pediatric Oncology Group (POG). Doses to inner ear and total cisplatin dose were correlated with hearing function by univariate and multivariate data analysis.Results: After a mean follow-up of 44 months (range: 14 to 72 months), 37 patients remained alive, with two recurrences, both in spine with CSF involvement, resulting in a disease free-survival and overall survival of 85.2% and 90.2%, respectively. Seven patients (17%) experienced POG Grade 3 or 4 toxicity. Cisplatin dose was a significant factor for hearing loss in univariate analysis (p < 0.03). in multivariate analysis, median dose to inner ear was significantly associated with hearing loss (p < 0.01). POG grade 3 and 4 toxicity were uncommon with median doses to the inner ear bellow 42 Gy (p < 0.05) and total cisplatin dose of less than 375 mg/m(2) (p < 0.01).Conclusions: IMRT leads to a low rate of severe ototoxicity. Median radiation dose to auditory apparatus should be kept below 42 Gy. Cisplatin doses should not exceed 375 mg/m(2).Instituto Israelita de Responsabilidade Social (IIRS) of Hospital Israelita Albert Einstein (HIAE)Hosp Israelita Albert Einstein HIAE, Dept Radiat Oncol, São Paulo, BrazilUniv São Paulo HCFMUSP, Fac Med, Hosp Clin, Dept Radiat Oncol, São Paulo, BrazilUniversidade Federal de São Paulo IOP GRAACC UNIFESP, Dept Pediat Oncol, Inst Oncol Pediat, Grp Apoio Ao Adolescente & Crianca Com Canc, São Paulo, BrazilUniversidade Federal de São Paulo IOP GRAACC UNIFESP, Dept Speech Therapy, Inst Oncol Pediat, Grp Apoio Ao Adolescente & Crianca Com Canc, São Paulo, BrazilUniv São Paulo HCFMUSP, Dept Pediat Oncol, Inst Tratamento Canc Infantil ITACI, Hosp Clin,Fac Med, São Paulo, BrazilUniversidade Federal de São Paulo IOP GRAACC UNIFESP, Dept Pediat Oncol, Inst Oncol Pediat, Grp Apoio Ao Adolescente & Crianca Com Canc, São Paulo, BrazilUniversidade Federal de São Paulo IOP GRAACC UNIFESP, Dept Speech Therapy, Inst Oncol Pediat, Grp Apoio Ao Adolescente & Crianca Com Canc, São Paulo, BrazilWeb of Science6engBiomed Central LtdRadiation OncologyMedulloblastomaHearing lossIntensity-modulated radiotherapyCisplatinQuality of lifeOtotoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective reviewinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALWOS000339593300001.pdfapplication/pdf299119${dspace.ui.url}/bitstream/11600/37996/1/WOS000339593300001.pdf6b373b04aa904b2e4ca0ddfc83f042adMD51open accessTEXTWOS000339593300001.pdf.txtWOS000339593300001.pdf.txtExtracted texttext/plain28439${dspace.ui.url}/bitstream/11600/37996/21/WOS000339593300001.pdf.txtf493d9be703b3b201c1c53fbd0906784MD521open accessTHUMBNAILWOS000339593300001.pdf.jpgWOS000339593300001.pdf.jpgIM Thumbnailimage/jpeg6611${dspace.ui.url}/bitstream/11600/37996/23/WOS000339593300001.pdf.jpg4a730edcbf01f51f9461363f1b9a2bf2MD523open access11600/379962023-06-05 19:48:55.653open accessoai:repositorio.unifesp.br:11600/37996Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-06-05T22:48:55Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review |
title |
Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review |
spellingShingle |
Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review Vieira, Wilson Albieri Medulloblastoma Hearing loss Intensity-modulated radiotherapy Cisplatin Quality of life |
title_short |
Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review |
title_full |
Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review |
title_fullStr |
Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review |
title_full_unstemmed |
Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review |
title_sort |
Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review |
author |
Vieira, Wilson Albieri |
author_facet |
Vieira, Wilson Albieri Weltman, Eduardo Chen, Michael Jenwei Silva, Nasjla Saba da [UNIFESP] Cappellano, Andrea Maria [UNIFESP] Pereira, Liliane Desgualdo [UNIFESP] Gonçalves, Maria Inês Rebelo [UNIFESP] Ferrigno, Robson Hanriot, Rodrigo Morais Nadalin, Wladimir Odone Filho, Vicente Petrilli, Antonio Sergio [UNIFESP] |
author_role |
author |
author2 |
Weltman, Eduardo Chen, Michael Jenwei Silva, Nasjla Saba da [UNIFESP] Cappellano, Andrea Maria [UNIFESP] Pereira, Liliane Desgualdo [UNIFESP] Gonçalves, Maria Inês Rebelo [UNIFESP] Ferrigno, Robson Hanriot, Rodrigo Morais Nadalin, Wladimir Odone Filho, Vicente Petrilli, Antonio Sergio [UNIFESP] |
author2_role |
author author author author author author author author author author author |
dc.contributor.institution.none.fl_str_mv |
Hosp Israelita Albert Einstein HIAE Universidade de São Paulo (USP) Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Vieira, Wilson Albieri Weltman, Eduardo Chen, Michael Jenwei Silva, Nasjla Saba da [UNIFESP] Cappellano, Andrea Maria [UNIFESP] Pereira, Liliane Desgualdo [UNIFESP] Gonçalves, Maria Inês Rebelo [UNIFESP] Ferrigno, Robson Hanriot, Rodrigo Morais Nadalin, Wladimir Odone Filho, Vicente Petrilli, Antonio Sergio [UNIFESP] |
dc.subject.eng.fl_str_mv |
Medulloblastoma Hearing loss Intensity-modulated radiotherapy Cisplatin Quality of life |
topic |
Medulloblastoma Hearing loss Intensity-modulated radiotherapy Cisplatin Quality of life |
description |
Background: Ototoxicity is a known side effect of combined radiation therapy and cisplatin chemotherapy for the treatment of medulloblastoma. the delivery of an involved field boost by intensity modulated radiation therapy (IMRT) may reduce the dose to the inner ear when compared with conventional radiotherapy. the dose of cisplatin may also affect the risk of ototoxicity. A retrospective study was performed to evaluate the impact of involved field boost using IMRT and cisplatin dose on the rate of ototoxicity.Methods: Data from 41 medulloblastoma patients treated with IMRT were collected. Overall and disease-free survival rates were calculated by Kaplan-Meier method Hearing function was graded according to toxicity criteria of Pediatric Oncology Group (POG). Doses to inner ear and total cisplatin dose were correlated with hearing function by univariate and multivariate data analysis.Results: After a mean follow-up of 44 months (range: 14 to 72 months), 37 patients remained alive, with two recurrences, both in spine with CSF involvement, resulting in a disease free-survival and overall survival of 85.2% and 90.2%, respectively. Seven patients (17%) experienced POG Grade 3 or 4 toxicity. Cisplatin dose was a significant factor for hearing loss in univariate analysis (p < 0.03). in multivariate analysis, median dose to inner ear was significantly associated with hearing loss (p < 0.01). POG grade 3 and 4 toxicity were uncommon with median doses to the inner ear bellow 42 Gy (p < 0.05) and total cisplatin dose of less than 375 mg/m(2) (p < 0.01).Conclusions: IMRT leads to a low rate of severe ototoxicity. Median radiation dose to auditory apparatus should be kept below 42 Gy. Cisplatin doses should not exceed 375 mg/m(2). |
publishDate |
2014 |
dc.date.issued.fl_str_mv |
2014-07-21 |
dc.date.accessioned.fl_str_mv |
2016-01-24T14:37:36Z |
dc.date.available.fl_str_mv |
2016-01-24T14:37:36Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Radiation Oncology. London: Biomed Central Ltd, v. 9, 6 p., 2014. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/37996 http://dx.doi.org/10.1186/1748-717X-9-158 |
dc.identifier.issn.none.fl_str_mv |
1748-717X |
dc.identifier.file.none.fl_str_mv |
WOS000339593300001.pdf |
dc.identifier.doi.none.fl_str_mv |
10.1186/1748-717X-9-158 |
dc.identifier.wos.none.fl_str_mv |
WOS:000339593300001 |
identifier_str_mv |
Radiation Oncology. London: Biomed Central Ltd, v. 9, 6 p., 2014. 1748-717X WOS000339593300001.pdf 10.1186/1748-717X-9-158 WOS:000339593300001 |
url |
http://repositorio.unifesp.br/handle/11600/37996 http://dx.doi.org/10.1186/1748-717X-9-158 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Radiation Oncology |
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info:eu-repo/semantics/openAccess |
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openAccess |
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6 |
dc.publisher.none.fl_str_mv |
Biomed Central Ltd |
publisher.none.fl_str_mv |
Biomed Central Ltd |
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Repositório Institucional da UNIFESP |
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