颅脑放疗和铂类化疗治疗顺序对儿童和青少年中枢神经系统和头颈部癌症患者听力损伤的影响：来自PanCareLIFE合作组织的报告。
The impact of the temporal sequence of cranial radiotherapy and platin-based chemotherapy on hearing impairment in pediatric and adolescent CNS and head-and-neck cancer patients: A report from the PanCareLIFE consortium.
发表日期：2023 Sep 15
作者：
Sergiu Scobioala, Ross Parfitt, Peter Matulat, Julianne Byrne, Thorsten Langer, Fabian M Troschel, Amélie E Hesping, Eva Clemens, Peter Kaatsch, Desiree Grabow, Melanie Kaiser, Claudia Spix, Leontien C Kremer, Gabriele Calaminus, Katja Baust, Claudia E Kuehni, Annette Weiss, Sven Strebel, Rahel Kuonen, Susanne Elsner, Riccardo Haupt, Maria-Luisa Garré, Bernd Gruhn, Tomas Kepak, Katerina Kepakova, Jeanette Falck Winther, Line Kenborg, Catherine Rechnitzer, Henrik Hasle, Jarmila Kruseova, Ales Luks, Herwig Lackner, Stefan Bielack, Jörn-Dirk Beck, Heribert Jürgens, Marry M van den Heuvel-Eibrink, Oliver Zolk, Hans Theodor Eich, Antoinette Am Zehnhoff-Dinnesen,
来源：
CLINICAL PHARMACOLOGY & THERAPEUTICS
摘要：
尚未详细研究颅内放射治疗（CRT）和铂类化疗（PCth）在儿童和青少年中枢神经系统（CNS）和头颈部（HN）肿瘤患者中的时间顺序对感音神经性听力损失（SNHL）的影响。我们检查了依次应用CRT和PCth的耳毒性作用。该研究纳入了参与多国PanCareLIFE（PCL）联盟的CNS和HN肿瘤儿童和青少年。对比了先接受CRT然后接受PCth的患者与先接受PCth然后接受CRT的患者的听觉结果。我们评估了141名患者中出现SNHL（定义为Muenster分类级别≥MS2b）的发病率、程度和治疗后的进展情况。其中119名患者纳入了发病时间分析。88名患者先接受CRT（组1），53名患者先接受PCth（组2）。在中位随访时间为1.6年的情况下，组1中72.7%的患者经历了SNHL≥ MS2b，而组2中为33.9%（P<.01）。对于组1的74名患者和组2的45名患者进行了发病时间分析。组1中HL≥MS2b的中位发病时间为1.2年，而组2为4.4年（P<.01）。因此，CRT后接受PCth的患者的听觉结果较好。这一发现应进一步评估并纳入临床实践，以减少CNS和HN肿瘤儿童和青少年的听力损失。© 2023 The Authors. International Journal of Cancer由John Wiley＆Sons Ltd代表UICC发表。
The impact of the temporal sequence by which cranial radiotherapy (CRT) and platin-based chemotherapy (PCth) are administered on sensorineural hearing loss (SNHL) in pediatric and adolescent central nervous system (CNS) and head-and-neck (HN) cancer patients has not yet been studied in detail. We examined the ototoxic effects of sequentially applied CRT and PCth. This study included children and adolescents with CNS and HN tumors who participated in the multicountry PanCareLIFE (PCL) consortium. Audiological outcomes were compared between patients who received CRT prior to PCth and those who received it afterwards. The incidence, degree and posttreatment progression of SNHL, defined as Muenster classification grade ≥MS2b, were evaluated in 141 patients. One hundred and nineteen patients were included in a time-to-onset analysis. Eighty-eight patients received CRT prior to PCth (Group 1) and 53 patients received PCth before CRT (Group 2). Over a median follow-up time of 1.6 years, 72.7% of patients in Group 1 experienced SNHL ≥ MS2b compared to 33.9% in Group 2 (P < .01). A time-to-onset analysis was performed for 74 patients from Group 1 and 45 patients from Group 2. Median time to hearing loss (HL) ≥ MS2b was 1.2 years in Group 1 and 4.4 years in Group 2 (P < .01). Thus, audiological outcomes were better for patients who received CRT after PCth than before. This finding should be further evaluated and considered within clinical practice in order to minimize hearing loss in children and adolescents with CNS and HN tumors.© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.