Sensorineural hearing loss in patients with head and neck cancer after chemoradiotherapy and radiotherapy: a systematic review of the literature.
BACKGROUND
Both radiotherapy (RT) and cisplatin-based chemoradiotherapy (CRT) in patients with head and neck cancer may cause sensorineural hearing loss (SNHL). The purpose of this review was to provide more insight into SNHL because of CRT compared to RT.


METHODS
Comprehensive search of Medline and Embase with the terms "radiotherapy" combined with "ototoxicity," "head and neck squamous cell carcinoma," and synonyms.


RESULTS
Of the 2507 studies found, 21 were included in this study. Pooled analysis could not be committed because of heterogeneity. Incidence rates of SNHL after RT and CRT varied considerably, with percentages ranging from 0% to 43% and 17% to 88%, respectively. Factors that influenced the risk of SNHL were radiation dose to the cochlea, follow-up time, age, baseline hearing level, and cisplatin dose.


CONCLUSIONS
The wide range of SNHL incidence rates makes it impossible to draw any conclusions on the severity of RT- and CRT-induced ototoxicity. To allow for future comparison of study outcomes, development of uniform criteria is of utmost importance.
Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Eleonoor A R
EA
Theunissen
Sophie C J
SC
Bosma
Charlotte L
CL
Zuur
René
R
Spijker
Sieberen
S
van der Baan
Wouter A
WA
Dreschler
Jan Paul
JP
de Boer
Alfons J M
AJ
Balm
Coen R N
CR
Rasch
D000367:Age Factors; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D059248:Chemoradiotherapy / Q000009:adverse effects*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003051:Cochlea / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006319:Hearing Loss, Sensorineural / Q000209:etiology*; D006801:Humans; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage
D000970:Antineoplastic Agents; D002945:Cisplatin
chemoradiotherapy; head and neck cancer; ototoxicity; radiotherapy; sensorineural hearing loss