Randomized evaluation of the audiologic outcome of ventilation tube insertion for middle ear effusion in patients with nasopharyngeal carcinoma

Objective: Complications after ventilation tube insertion for middle ear effusion in patients with nasopharyngeal carcinoma are frequent. This may compromise the overall benefit obtained from the procedure. This study evaluates the hearing improvement after tube insertion compared with observation alone to see if the benefits of the procedure outweigh its potential complications. Design: Prospective randomized controlled trial. Setting: Full clinical and emergency otolaryngologic services hospital in an academic institution. Methods: Patients with nasopharyngeal carcinoma and middle ear effusion were randomized for preradiotherapy ventilation tube insertion or observation. Audiologic assessment with a pure-tone audiogram was performed before the procedure, after ventilation tube insertion, and at fixed intervals after irradiation. Audiologic outcome was compared between the two groups. Main Outcome Measure: Air-conduction threshold and air-bone gap on a pure-tone audiogram at different intervals after radiotherapy. Results: There was no significant difference in hearing threshold changes between the two groups for up to 4 years. Both groups had air-bone gap improvement following radiotherapy and the improvement was not significantly different between the two groups. The proportion of patients with closure of the air-bone gap on follow-up was not different between the two groups. Conclusions: Ventilation tube insertion before radiotherapy did not offer additional hearing benefit when compared with observation alone. The procedure had no deleterious effect on hearing for up to 4 years.link_to_subscribed_fulltex

Sensorineural hearing loss in patients treated for nasopharyngeal carcinoma: A prospective study of the effect of radiation and cisplatin treatment

Purpose: The pattern of sensorineural hearing loss (SNHL) after primary treatment for nasopharyngeal carcinoma (NPC) was studied, and the effect of cisplatin, radiotherapy dose, and fractionation were evaluated. Methods and Materials: One hundred thirty-two patients, 227 ears, and 1100 audiogram reports were analyzed. Radiotherapy dose ranged from 59.5 to 76.5 Gy. Fifty- two patients received preirradiation cisplatin, total dose 100-185 mg/m 2. Serial postirradiation bone conduction thresholds at 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz were compared with pretreatment thresholds at respective frequencies. Increase of at least 15 dB was considered as significant and was further grouped as transient or persistent SNHL. Univariate and multivariate analyses were performed to identify predicting factors for persistent SNHL. Results: At median follow-up of 30 months, 24.2% of ears developed persistent SNHL. High frequency was more affected than low frequencies, 22 vs. 5.3%. Males were more affected than females, 29.4 vs. 15.5%, p = 0.0132. Incidence of persistent SNHL increased with age, with 0, 17.2, and 37.4% of patients aged under 30, between 30-50 and over 50 affected, respectively, p = 0.0001. High incidence was found in patient with postirradiation serous otitis media (SOM), 46.9%. Chemotherapy with cisplatin and radiation dose or fractionation had no significant effect. Multivariate analysis confirmed age, sex, and postirradiation SOM as significant prognostic factors for persistent SNHL. Conclusions: Transient and persistent SNHL occurred after radiotherapy, more commonly affecting high frequency. A low dose of preirradiation cisplatin did not increase the risk. A dose fractionation effect of radiotherapy was not confirmed in this study.link_to_subscribed_fulltex

Prevalence of psychosocial unmet needs of Chinese women facing advanced breast cancer

Conference Theme: Unmet needs of people touched by cancerAbstract and poster presentationThe 2nd Meeting of East Asia Psycho-oncology Society (EAPOS): Unmet needs of people touched by cancer, Hong Kong, China, 23-24 August 2010

Change patterns in supportive care needs among women diagnosed with advanced breast cancer

Young Investigator Award: Psychosocial OncologyConference Theme: Integration and Collaboration - the Way Forwar

Longitudinal Trends Relating to Fear of Recurrence Amongst Head and Neck Cancer Survivors

Poster abstractlink_to_OA_fulltextThe 13th World Congress of Psycho-Oncology, Antalya, Turkey, 16–20 October 2011. In Psycho-Oncology, 2011, v. 20 n. Suppl. 2, p. 198-199, abstract no. P2-