ArticleRadiation oncology (London, England)2015
Normal tissue complication probability modeling for cochlea constraints to avoid causing tinnitus after head-and-neck intensity-modulated radiation therapy.
Article in Radiation oncology (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Prognostic models for radiation-induced complications after radiotherapy in head and neck cancer patients.The Cochrane database of systematic reviews · 2025Pooled it
- Ototoxicity prognostic models in adult and pediatric cancer patients: a rapid review.Journal of cancer survivorship : research and practice · 2023Pooled it
- Dosimetric analysis of different whole brain radiotherapy treatment planning methods: three types of 3-dimensional versus hippocampal avoidant.Radiation oncology journal · 2025Article
- Hearing Loss and Middle Ear Effusion in Nasopharyngeal Carcinoma Following Radiotherapy: Dose-Response Relationship and Normal Tissue Complication Probability Modeling.International archives of otorhinolaryngology · 2025Article
- Radiotherapy toxicities: mechanisms, management, and future directions.Lancet (London, England) · 2025Review
- Dosimetric and NTCP analyses for selecting parotid gland cancer patients for proton therapy.Tumori · 2024Article
- Establishment and risk factor assessment of the abnormal body temperature probability prediction model (ABTP) for dairy cattle.Scientific reports · 2024Article
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- Patient-reported measures of tinnitus for individuals with neurofibromatosis type 2-related schwannomatosis: Recommendations for clinical trials.Clinical trials (London, England) · 2024Article
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- Ototoxicity in Patients of Advanced Head and Neck Malignancies Receiving Chemoradiation Versus Radiation Alone: Comparative Study.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2022Article
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- Proton Radiation Therapy for Nasopharyngeal Cancer Patients: Dosimetric and NTCP Evaluation Supporting Clinical Decision.Cancers · 2022Article
- Treatment plan comparison of proton vs photon radiotherapy for lower-grade gliomas.Physics and imaging in radiation oncology · 2021Article
- Cochlea sparing optimized radiotherapy for nasopharyngeal carcinoma.Radiation oncology (London, England) · 2021Article
- NTCP Modeling of Late Effects for Head and Neck Cancer: A Systematic Review.International journal of particle therapy · 2021Article
- Increased cochlear radiation dose predicts delayed hearing loss following both stereotactic radiosurgery and fractionated stereotactic radiotherapy for vestibular schwannoma.Journal of neuro-oncology · 2019Article
- Chemoradiation-induced hearing loss remains a major concern for head and neck cancer patients.International journal of audiology · 2018Review
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRadiation-induced tinnitus is a side effect of radiotherapy in the inner ear for cancers of the head and neck. Effective dose constraints for protecting the cochlea are under-reported. The aim of this study is to determine the cochlea dose limitation to avoid causing tinnitus after head-and-neck cancer (HNC) intensity-modulated radiation therapy (IMRT).
methodsIn total 211 patients with HNC were included; the side effects of radiotherapy were investigated for 422 inner ears in the cohort. Forty-nine of the four hundred and twenty-two samples (11.6%) developed grade 2+ tinnitus symptoms after IMRT, as diagnosed by a clinician. The Late Effects of Normal Tissues-Subjective, Objective, Management, Analytic (LENT-SOMA) criteria were used for tinnitus evaluation. The logistic and Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) models were used for the analyses.
resultsThe NTCP-fitted parameters were TD 50 = 46.31 Gy (95% CI, 41.46-52.50), γ 50 = 1.27 (95% CI, 1.02-1.55), and TD 50 = 46.52 Gy (95% CI, 41.91-53.43), m = 0.35 (95% CI, 0.30-0.42) for the logistic and LKB models, respectively. The suggested guideline TD 20 for the tolerance dose to produce a 20% complication rate within a specific period of time was TD 20 = 33.62 Gy (95% CI, 30.15-38.27) (logistic) and TD 20 = 32.82 Gy (95% CI, 29.58-37.69) (LKB).
conclusionsTo maintain the incidence of grade 2+ tinnitus toxicity <20% in IMRT, we suggest that the mean dose to the cochlea should be <32 Gy. However, models should not be extrapolated to other patient populations without further verification and should first be confirmed before clinical implementation.
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