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://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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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 |
_version_ |
1814268366720860160 |