Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review

Detalhes bibliográficos
Autor(a) principal: Vieira, Wilson Albieri
Data de Publicação: 2014
Outros Autores: 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]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.1186/1748-717X-9-158
http://repositorio.unifesp.br/handle/11600/37996
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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spelling Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective reviewMedulloblastomaHearing lossIntensity-modulated radiotherapyCisplatinQuality of lifeBackground: 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).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 ScienceInstituto Israelita de Responsabilidade Social (IIRS) of Hospital Israelita Albert Einstein (HIAE)Biomed Central LtdHosp Israelita Albert Einstein HIAEUniversidade de São Paulo (USP)Universidade Federal de São Paulo (UNIFESP)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]2016-01-24T14:37:36Z2016-01-24T14:37:36Z2014-07-21info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion6application/pdfhttp://dx.doi.org/10.1186/1748-717X-9-158Radiation Oncology. London: Biomed Central Ltd, v. 9, 6 p., 2014.10.1186/1748-717X-9-158WOS000339593300001.pdf1748-717Xhttp://repositorio.unifesp.br/handle/11600/37996WOS:000339593300001engRadiation Oncologyinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-01T02:15:42Zoai:repositorio.unifesp.br/:11600/37996Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-01T02:15:42Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.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.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.por.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.none.fl_str_mv 2014-07-21
2016-01-24T14:37:36Z
2016-01-24T14:37:36Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1186/1748-717X-9-158
Radiation Oncology. London: Biomed Central Ltd, v. 9, 6 p., 2014.
10.1186/1748-717X-9-158
WOS000339593300001.pdf
1748-717X
http://repositorio.unifesp.br/handle/11600/37996
WOS:000339593300001
url http://dx.doi.org/10.1186/1748-717X-9-158
http://repositorio.unifesp.br/handle/11600/37996
identifier_str_mv Radiation Oncology. London: Biomed Central Ltd, v. 9, 6 p., 2014.
10.1186/1748-717X-9-158
WOS000339593300001.pdf
1748-717X
WOS:000339593300001
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Radiation Oncology
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 6
application/pdf
dc.publisher.none.fl_str_mv Biomed Central Ltd
publisher.none.fl_str_mv Biomed Central Ltd
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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