title: Hearing loss in survivors of childhood head and neck rhabdomyosarcoma: a long-term follow-up study.
abstract: OBJECTIVE
  To determine the hearing status of survivors treated for head and neck rhabdomyosarcoma (HNRMS) at long-term follow-up.
  
  
  METHODS
  Cross-sectional long-term follow-up study.
  
  
  METHODS
  Tertiary comprehensive cancer centre.
  
  
  METHODS
  Survivors treated for HNRMS during childhood in two concurrent cohorts; survivors in London had been treated with external beam radiotherapy (EBRT-based local therapy); survivors in Amsterdam were treated with AMORE (Ablative surgery, MOuld technique afterloading brachytherapy and surgical REconstruction) if feasible, otherwise EBRT (AMORE-based local therapy).
  
  
  METHODS
  We assessed hearing status of HNRMS survivors at long-term follow-up. Hearing thresholds were obtained by pure-tone audiometry.
  
  
  METHODS
  We assessed the hearing thresholds, the number of patients with clinically relevant hearing loss and hearing impairment graded according to the Common Terminology Criteria for Adverse Events version 4.0 (CTCAEv4) and Boston criteria. Furthermore, we compared hearing loss between survivors treated with EBRT-based local therapy (London) and AMORE-based local therapy (Amsterdam).
  
  
  RESULTS
  Seventy-three survivors were included (median follow-up 11 years). We found clinically relevant hearing loss at speech frequencies in 19% of survivors. Multivariable analysis showed that survivors treated with EBRT-based treatment and those with parameningeal tumours had significantly more hearing impairment, compared to survivors treated with AMORE-based treatment and non-parameningeal tumours.
  
  
  CONCLUSIONS
  One in five survivors of HNRMS developed clinically relevant hearing loss. AMORE-based treatment resulted in less hearing loss compared to EBRT-based treatment. As hearing loss was highly prevalent and also occurred in survivors with orbital primaries, we recommend systematic audiological follow-up in all HNRMS survivors.
authors: Department of Paediatric Oncology, Emma Children's Hospital, Academic Medical Centre, Amsterdam, the Netherlands.
authors: R A
authors: RA
authors: Schoot
authors: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors: E A R
authors: EA
authors: Theunissen
authors: Department of Paediatric Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors: O
authors: O
authors: Slater
authors: Department of Epidemiology and Biostatistics, the Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors: M
authors: M
authors: Lopez-Yurda
authors: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors: C L
authors: CL
authors: Zuur
authors: Department of Paediatric Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
authors: M N
authors: MN
authors: Gaze
authors: Department of Paediatric Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
authors: Y-C
authors: YC
authors: Chang
authors: Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, Sutton, UK.
authors: H C
authors: HC
authors: Mandeville
authors: Department of Paediatric Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
authors: J E
authors: JE
authors: Gains
authors: Department of Audiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors: K
authors: K
authors: Rajput
authors: Department of Radiation Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
authors: B R
authors: BR
authors: Pieters
authors: Department of Radiation Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
authors: R
authors: R
authors: Davila Fajardo
authors: Department of Otorhinolaryngology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors: R
authors: R
authors: Talwar
authors: Department of Paediatric Oncology, Emma Children's Hospital, Academic Medical Centre, Amsterdam, the Netherlands.
authors: H N
authors: HN
authors: Caron
authors: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors: A J M
authors: AJ
authors: Balm
authors: Department of Audiology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
authors: W A
authors: WA
authors: Dreschler
authors: Department of Paediatric Oncology, Emma Children's Hospital, Academic Medical Centre, Amsterdam, the Netherlands.
authors: J H M
authors: JH
authors: Merks
mesh_terms: D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000628:therapy*; D034381:Hearing Loss / Q000209:etiology*; D006801:Humans; D007223:Infant; D008131:London; D008297:Male; D009426:Netherlands; D012208:Rhabdomyosarcoma / Q000628:therapy*; D017741:Survivors