Influencing factors and nursing implications of hearing impairment in patients with post-radiotherapy nasopharyngeal cancer

doi:10.3761/j.issn.0254-1769.2026.01.012

Abstract

Abstract:

Objective To investigate the status and risk factors of hearing impairment after radiotherapy in patients with nasopharyngeal carcinoma，in order to provide a reference for the prevention and control of hearing impairment. Methods Using a stratified random sampling method，a follow-up survey was conducted among 431 patients with nasopharyngeal carcinoma who had undergone radiotherapy in a tertiary hospital of Foshan from October 2023 to March 2025. General information，disease-related data，post-radiotherapy ear care behaviors，and complications data from follow-up were collected，and hearing impairment was assessed. The major factors associated with hearing impairment after radiotherapy were analyzed using the random forest algorithm and elastic net regression. Results Within 1~12 years after radiotherapy，the mean hearing threshold of patients was（47.37±21.90）dB，with an overall incidence of hearing impairment of 73.78%（318/431）. Univariate analysis，random forest algorithm，and elastic net regression revealed 6 major risk factors，including the number of years since radiotherapy，cisplatin dosage，age，time to first onset of otitis media after radiotherapy，number of ear-related complications，and eustachian tube function exercises within the first 2 years. Conclusion The incidence of hearing impairment of post-radiotherapy nasopharyngeal cancer is high. Clinical medical staff should optimize treatment plans and pay close attention to the prevention and management of post-radiotherapy ear complications，in order to slow the progression and severity of hearing impairment.

Key words: Nasopharyngeal Carcinoma, Hearing Impairment, Random Forest, Root Caused Analysis, Nursing Care

摘要：

目的探讨鼻咽癌放疗后听力损伤的发生现状及其影响因素，为听力损伤的防控提供参考。方法采用分层随机抽样法，于2023年10月—2025年3月选取佛山市某三级甲等医院的431例鼻咽癌放疗后患者进行调查，收集患者的疾病资料、放疗后耳部护理行为及并发症等随访资料，并评估听力损伤情况。采用随机森林算法与弹性网络回归，分析并确定影响放疗后听力损伤的主要影响因素。结果鼻咽癌放疗后1~12年内，患者平均听阈为（47.37±21.90）dB，听力损伤总体发生率为73.78%（318/431）。经单因素分析、随机森林算法及弹性网络回归分析结果显示，放疗后年限、顺铂剂量、年龄、放疗后中耳炎首次出现时间、耳部并发症数量及前2年内咽鼓管功能锻炼情况是鼻咽癌放疗后听力损伤的主要影响因素。结论鼻咽癌放疗后听力损伤发生率较高，临床医护人员应在优化治疗方案减少听力损伤的同时，重视放疗后耳部并发症的预防与处理，以延缓听力损伤的发生进程并减轻其严重程度。

关键词: 鼻咽癌, 听力损伤, 随机森林, 影响因素分析, 护理

JIANG Xiangling, LU Huifen, YU Youjun, LIN Xiaoli, HUANG Peiling. Influencing factors and nursing implications of hearing impairment in patients with post-radiotherapy nasopharyngeal cancer[J]. Chinese Journal of Nursing, 2026, 61(1): 85-92.

蒋向玲, 陆慧芬, 虞幼军, 林晓丽, 黄佩铃. 鼻咽癌患者放疗后听力损伤影响因素研究及护理启示[J]. 中华护理杂志, 2026, 61(1): 85-92.

Figures/Tables 6

Table 1 Univariate analysis of general data and mean hearing threshold in patients after radiotherapy for nasopharyngeal carcinoma（n=431）

Table 2 Analysis of hearing impairment following radiotherapy for nasopharyngeal carcinoma within 1~12 years（n=431）

Table 3 Independent-variable assignment method

Table 4 Optimal ranges and optimal values of hyperparameter tuning for the random forest model of hearing impairment after radiotherapy for nasopharyngeal carcinoma

Figure 1 Ranking of variable importance scores for random forest prediction model

Table 5 Multifactorial analysis of hearing impairment after radiotherapy for nasopharyngeal carcinoma（n=431）

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