Risk factors associated with ototoxicity in long-term nasopharyngeal carcinoma survivors

作者全名：He, Shuangshuang; Yu, Hang; He, Ling; Liu, Mengyuan; He, Yan; Peng, Xingchen; Ai, Ping

作者地址：[He, Shuangshuang; Liu, Mengyuan; Ai, Ping] Sichuan Univ, West China Hosp, Dept Radiat Oncol, Chengdu 610041, Sichuan, Peoples R China; [He, Shuangshuang; Liu, Mengyuan; Ai, Ping] Sichuan Univ, West China Hosp, Canc Ctr, Dept Head & Neck Oncol, Chengdu 610041, Sichuan, Peoples R China; [Yu, Hang] Sichuan Univ, West China Hosp, Dept Radiotherapy Phys & Technol, Chengdu 610041, Sichuan, Peoples R China; [He, Ling; Peng, Xingchen] Sichuan Univ, West China Hosp, Canc Ctr, Dept Biotherapy, Chengdu 610041, Sichuan, Peoples R China; [He, Yan] Chongqing Med Univ, Dept Oncol, Affiliated Hosp 2, Chongqing, Peoples R China

通信作者：Ai, P (通讯作者)，Sichuan Univ, West China Hosp, Dept Radiat Oncol, Chengdu 610041, Sichuan, Peoples R China.; Ai, P (通讯作者)，Sichuan Univ, West China Hosp, Canc Ctr, Dept Head & Neck Oncol, Chengdu 610041, Sichuan, Peoples R China.; Peng, XC (通讯作者)，Sichuan Univ, West China Hosp, Canc Ctr, Dept Biotherapy, Chengdu 610041, Sichuan, Peoples R China.

来源：ORAL ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001241366100001

JCR分区：Q1

影响因子：4

年份：2024

卷号：154

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：Nasopharyngeal carcinoma; Patient-reported outcomes; Intensity-modulated radiotherapy; Long-term survivor; Ototoxicity

摘要：Purpose: To investigate patient-reported outcomes among long-term survivors and to analyze their associated risk factors to provide better treatment and symptom management for nasopharyngeal carcinoma patients. Materials and methods: This retrospective study collected patients diagnosed with nasopharyngeal carcinoma who received radical intensity-modulated radiotherapy in our hospital from June 2009 to June 2016. The patients' disease status and patient-reported outcomes were analyzed by follow-up. The ototoxicity was graded according to CTCAE 5.0. Results: A total of 223 patients were included in the study. Among the enrolled patients, the median follow-up time was 8.4 (6.0-13.0) years. Based on the patient-reported outcomes, ototoxicity was the most common symptom (52.9 %). After univariable and multivariable logistic regression, age >= 50 years old (OR, 4.066; 95 % CI, 1.799-9.190; P = .001), diabetes (OR, 3.520; 95 % CI, 1.442-8.591; P = .006), D2 >= 69 Gy (OR, 3.715; 95 % CI, 1.064-12.969; P = . 040) and V35 >= 91.5 % (OR, 3.398; 95 % CI, 1.113-10.372; P = .032) were associated with a higher incidence of grade 3-4 ototoxicity. Then, we constructed the individual nomogram and the C index of the graph was 0.815. By univariable logistic regression, we found that grade 3-4 ototoxicity was associated with an increased risk of multiple other symptoms, dysmasesia, tongue dysfunction, hoarseness, dysphagia and ocular toxicity. Conclusion: In long-term survivors of nasopharyngeal carcinoma patients receiving IMRT, the most common patient-reported outcome was ototoxicity. Age >= 50 years, diabetes, ear exposure dose of D2 >= 69 Gy and V35 >= 91.5 % are independent risk factors for grade 3-4 ototoxicity.

基金机构：National Key Research and Development Program of China [2021YFE0206600]; National Natural Science Foundation of China [82172842, 81672386]; Sichuan Science and Technology Program [2022YFSY0012, 2021ZYCD011, 2021YFSY0008, 2021CDDZ-25, 2021CDZG-24]; Chengdu International Science and Technology Cooperation Program [2022-GH03-00004-HZ]; West China Nursing Discipline Development Special Fund Project [HXHL21008]; Post-Doctor Research Project, West China Hospital, Sichuan University [2020HXBH119]; Translational medicine fund of West China Hospital [CGZH19002]; China Medical Board [22-482]; Clinical Research Incubation Project of West China Hospital [20HXFH037]; The 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University [2021HXFH050]

基金资助正文：The work was supported by the National Key Research and Development Program of China (2021YFE0206600) , National Natural Science Foundation of China (82172842and81672386) , Sichuan Science and Technology Program (2022YFSY0012, 2021ZYCD011, 2021YFSY0008, 2021CDDZ-25, 2021CDZG-24) , Chengdu International Science and Technology Cooperation Program (2022-GH03-00004-HZ) , West China Nursing Discipline Development Special Fund Project (HXHL21008) , the Post-Doctor Research Project, West China Hospital, Sichuan University (2020HXBH119) , Translational medicine fund of West China Hospital (CGZH19002) , the China Medical Board (Grant #22-482) , Clinical Research Incubation Project of West China Hospital (20HXFH037) , and 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (2021HXFH050) .