[Late neurotoxicity after nasopharyngeal carcinoma treatment].
OBJECTIVE
A retrospective analysis of risk factors for late neurological toxicity after nasopharyngeal carcinoma radiotherapy.


METHODS
Between 1993 and 2004, 239 patients with non metastatic nasopharyngeal carcinoma were treated by radiotherapy associated or not to chemotherapy. Radiotherapy was delivered with two modalities: hyperfractionated for 82 patients and conventional fractionation for 157 patients. We evaluated the impact of tumour stage, age, gender, radiotherapy schedule and chemotherapy on neurological toxicity.


RESULTS
After a mean follow-up of 107 months (35-176 months), 21 patients (8.8%) developed neurological complications, such as temporal necrosis in nine cases, brain stem necrosis in five cases, optics nerve atrophy in two cases and myelitis in one case. Five- and ten-year free of toxicity survival was 95 and 84% respectively. Young patients had greater risk of temporal necrosis, and hyperfractionated radiotherapy was associated with a significantly higher risk of neurological complications (14.6% vs 5.7%, p=0.02). On multivariate analysis, hyperfractionation and age were insignificant.


CONCLUSIONS
Late neurological toxicity after radiotherapy for nasopharyngeal carcinoma was rare. Younger age and hyperfractionation were considered as risk factors of neurological toxicity in our study.
Siala
W
W
Service de radiothérapie carcinologique, hôpital Habib-Bourguiba, Sfax, Tunisia.
Mnejja
W
W
Khabir
A
A
Ben Mahfoudh
K
K
Boudawara
T
T
Ghorbel
A
A
Frikha
M
M
Daoud
J
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001284:Atrophy / Q000209:etiology; D001933:Brain Stem / Q000473:pathology; D002277:Carcinoma / Q000401:mortality / Q000532:radiotherapy*; D002648:Child; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009187:Myelitis / Q000209:etiology; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D009336:Necrosis / Q000209:etiology; D009900:Optic Nerve / Q000473:pathology; D011832:Radiation Injuries / Q000150:complications*; D012189:Retrospective Studies; D013701:Temporal Bone / Q000473:pathology