title: Central nervous system infection in patients with postirradiated nasopharyngeal carcinoma: a case-controlled study.
abstract: BACKGROUND
  It has been assumed that postirradiated nasopharyngeal carcinoma (NPC) patients are prone to central nervous system (CNS) infection.
  
  
  OBJECTIVE
  The purpose of this study was to better understand this clinical entity.
  
  
  METHODS
  From September 1989 to May 2006, we conducted a retrospective study of 18 postirradiated NPC patients with CNS infection including brain abscess, cavernous sinus thrombosis, epidural abscess, and meningitis in our institute. During the same period, 18 NPC patients without CNS infection who were matched for tumor stage, age, and gender with the study group were randomly selected from the cancer registry at our hospital and enrolled as the control group. All medical records of these patients were evaluated.
  
  
  RESULTS
  The local tumor relapse rate, nasopharyngeal radiotherapy dose, and skull base osteoradionecrosis were all significantly higher in patients with CNS infection (p = 0.003, 0.011, and 0.001, respectively). Although the incidences of otitis media and chronic rhinosinusitis were higher in patients with CNS infection, there were no significant differences between the two groups (p = 0.469 and 0.568, respectively). The in-hospital mortality was 61.1%, and the overall mortality of CNS infection was 83.3%. There was a significant difference in overall survival rate between the two groups (p = 0.001).
  
  
  CONCLUSIONS
  Postirradiated NPC patients with skull base osteoradionecrosis are prone to have CNS infection. CNS infection is an adverse prognostic factor in postirradiated NPC patients.
authors: Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan. kellyliang1107@gmail.com
authors: Kai-Li
authors: KL
authors: Liang
authors: Rong-San
authors: RS
authors: Jiang
authors: Jin-Ching
authors: JC
authors: Lin
authors: Yu-Jung
authors: YJ
authors: Chiu
authors: Jiun-Yih
authors: JY
authors: Shiao
authors: Mao-Chang
authors: MC
authors: Su
authors: Chung-Han
authors: CH
authors: Hsin
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002277:Carcinoma / Q000473:pathology / Q000532:radiotherapy*; D002490:Central Nervous System / Q000528:radiation effects*; D002494:Central Nervous System Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D004307:Dose-Response Relationship, Radiation; D004724:Endoscopy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014057:Tomography, X-Ray Computed