Ototoxicity and cochlear sparing in children with medulloblastoma: Proton vs. photon radiotherapy. Issue 1 (July 2018)

• Record Type: Journal Article
• Authors: Paulino, Arnold C.; Mahajan, Anita; Ye, Rong; Grosshans, David R.; Fatih Okcu, M.; Su, Jack; McAleer, Mary Frances; McGovern, Susan; Mangona, Victor A.; Chintagumpala, Murali
• Is Part Of: Radiotherapy and oncology. Volume 128:Issue 1(2018)
• Page Start: 128
• Page End: 132
• Publication Date: 2018-07
• Subjects: Ototoxicity -- Medulloblastoma -- Proton therapy -- Intensity modulated radiation therapy; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2018.01.002
• Languages: English
• ISSNs: 0167-8140

Abstract

Abstract: Purpose: To compare ototoxicity rates between medulloblastoma patients treated with protons vs. photons. Materials and methods: The study included 84 children diagnosed with medulloblastoma treated with either passively scattered protons ( n = 38) or photons ( n = 46). Patients underwent maximal safe resection followed by craniospinal irradiation, posterior fossa and/or tumor bed boost and chemotherapy according to one of 3 multi-institutional trials. Median audiogram follow-up was 56 months for protons and 66 months for photons. Results: Mean cochlear dose (Dmc ) was lower in patients treated with protons for both standard ( p < 0.0001) and high-risk disease ( p < 0.001). Grade 3 and 4 ototoxicity was seen in 7 of 75 (9.3%) and 9 of 91 (9.9%) ears (Brock, p = 0.91), 13 of 75 (17.3%) and 19 of 91 (20.9%) ears (POG, p = 0.56), and 15 of 75 (20.0%) and 21 of 91 (23.1%) ears (SIOP Boston, p = 0.63) with protons and photons respectively. Conclusions: While cochlear doses were lower in the proton group, patients treated with either protons or photons had similar Grade 3 and 4 ototoxicity rates.