Impact of Cancer Type and Anatomical Radiation Exposure on the Incidence of Radiotherapy-Induced Otitis Media with Effusion in Head and Neck Cancer Patients

Abstract

Objective: This study aimed to investigate the influence of cancer type on radiotherapy-induced otitis media with effusion (RTOME) occurrence and to assess the impact of anatomical region-specific radiation exposure on both RTOME incidence rates and associated pathogenic processes. Methods: A retrospective analysis was conducted on 1046 head and neck cancer (HNC) patients who underwent radiotherapy at Peking Union Medical College Hospital between 2016 and 2023. The incidence of RTOME was assessed across various cancer types, and the radiation exposure probabilities of different head and neck regions were compared between patients with and without RTOME using the chi-squared test (χ2) test and the Mann-Whitney U test. Results: The overall incidence of RTOME in patients with HNC was 5.83%. The incidence varied significantly by cancer type, with nasopharyngeal carcinoma showing the highest rate (17.40%), followed by ocular and orbital cancers (6.25%), nasal cavity and paranasal sinus cancer (4.35%), oral cavity and oropharyngeal cancers (4.32%), laryngeal and hypopharyngeal cancers (0.32%), and thyroid cancers (0%). Furthermore, patients with RTOME exhibited significantly-higher radiation exposure frequencies in five specific anatomical regions: the skull base and intracranial, parotid and periauricular, nasal cavity and paranasal sinuses, nasopharynx, and parapharyngeal space, than those without RTOME. Conclusions: The incidence of RTOME is strongly associated with both cancer type and radiation exposure to specific anatomical regions. Radiation targeting certain areas may increase the risk of developing RTOME.