TY - JOUR
T1 - Ototoxicity and cochlear sparing in children with medulloblastoma
T2 - Proton vs. photon radiotherapy
AU - Paulino, Arnold C.
AU - Mahajan, Anita
AU - Ye, Rong
AU - Grosshans, David R.
AU - Fatih Okcu, M.
AU - Su, Jack
AU - McAleer, Mary Frances
AU - McGovern, Susan
AU - Mangona, Victor A.
AU - Chintagumpala, Murali
PY - 2018/7
Y1 - 2018/7
N2 - 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.
AB - 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.
KW - Intensity modulated radiation therapy
KW - Medulloblastoma
KW - Ototoxicity
KW - Proton therapy
UR - http://www.scopus.com/inward/record.url?scp=85040560454&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85040560454&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2018.01.002
DO - 10.1016/j.radonc.2018.01.002
M3 - Article
C2 - 29373195
AN - SCOPUS:85040560454
SN - 0167-8140
VL - 128
SP - 128
EP - 132
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -