Sensorineural hearing loss in patients with head and neck cancer after chemoradiotherapy and radiotherapy: a systematic review of the literature

Head Neck. 2015 Feb;37(2):281-92. doi: 10.1002/hed.23551. Epub 2014 Jan 29.

Abstract

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.

Conclusion: 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.

Keywords: chemoradiotherapy; head and neck cancer; ototoxicity; radiotherapy; sensorineural hearing loss.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Age Factors
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Chemoradiotherapy / adverse effects*
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Cochlea / drug effects
  • Dose-Response Relationship, Drug
  • Head and Neck Neoplasms / therapy*
  • Hearing Loss, Sensorineural / etiology*
  • Humans
  • Radiotherapy / adverse effects*
  • Radiotherapy Dosage

Substances

  • Antineoplastic Agents
  • Cisplatin