Cerebral radionecrosis in patients with nasopharyngeal carcinoma.
This study involved seven patients with cerebral radionecrosis following radiation therapy for nasopharyngeal carcinoma (NPC). Their charts were reviewed and the relationship of extracranial malignancies to cerebral radionecrosis was investigated. The radiation dose ranged from 70 to 135 Gy, and the latency was from 6 to 39 months. Two of seven patients died of NPC-related complications during follow-up. The crude incidence of cerebral radionecrosis in patients with NPC was 0.93% in our series. Improvement of symptoms could be achieved by corticosteroid therapy, with or without surgery. In a review of the literature, there were 306 cases of cerebral radionecrosis in extracranial malignancies. The nasopharynx is the most common primary site in cerebral radionecrosis of extracranial malignancies, followed by the scalp and sinonasal tract. The 3-year overall survival rate in our series was 68.57%, as provided by the Kaplan-Meier product limited method. Cerebral radionecrosis in NPC patients should be differentiated from tumor recurrence, in order to apply the appropriate treatment.
Hsu
Ying-Che
YC
Department of Otolaryngology, Kaohsiung Medical University Chun-Ho Memorial Hospital, Taiwan.
Wang
Ling-Feng
LF
Lee
Ka-Wo
KW
Ho
Kuen-Yao
KY
Huang
Chih-Jen
CJ
Kuo
Wen-Rei
WR
D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology / Q000528:radiation effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D009305:Nasopharynx / Q000473:pathology / Q000528:radiation effects; D009336:Necrosis; D009367:Neoplasm Staging; D011832:Radiation Injuries / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome