title: Comparison of radiological and clinical features of temporal lobe necrosis in nasopharyngeal carcinoma patients treated with 2D radiotherapy or intensity-modulated radiotherapy.
abstract: BACKGROUND
  To compare the imaging and clinical features of temporal lobe necrosis (TLN) in nasopharyngeal carcinoma (NPC) patients treated with two-dimensional radiotherapy (2D-RT) or those with intensity-modulated radiotherapy (IMRT).
  
  
  METHODS
  We retrospectively analysed NPC patients who underwent 2D-RT (72 patients, 128 temporal lobes) or IMRT (36 patients, 50 lobes) and developed radiation-induced, MRI-confirmed TLN.
  
  
  RESULTS
  White-matter lesions (WMLs), contrast-enhanced lesions, cysts and local mass effects were present in 128 out of 128 vs 48 out of 50 (P=0.078), 123 out of 128 vs 47 out of 50 (P=0.688), 10 out of 128 vs 1 out of 50 (P=0.185) and 57 out of 128 vs 13 out of 50 (P=0.023) temporal lobes, respectively, in the 2D-RT and IMRT groups. The WMLs were more extensive in the 2D-RT group (P<0.001). The maximum diameter of contrast-enhanced lesions was greater in the 2D-RT group (P<0.001), and these lesions tended to extend far away from the nasopharynx. The WMLs and enhancement had no impact on cyst development (both P=1). Local mass effects were always accompanied with contrast-enhanced lesions (P=0.024) but were not correlated with WMLs or cysts (P=0.523 and 0.341, respectively). There were no between-group differences in clinical features (all P-values>0.05), whereas the difference in the incidence of severe debility was of marginal significance (18.1% vs 5.6%, P=0.077).
  
  
  CONCLUSIONS
  The IMRT-induced TLN was less extensive and milder than 2D-RT-induced TLN, but both had similar clinical features.
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.
authors.forename: Y-P
authors.initials: YP
authors.lastname: Mao
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.
authors.forename: G-Q
authors.initials: GQ
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Imaging Diagnosis and Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: L-Z
authors.initials: LZ
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.
authors.forename: R
authors.initials: R
authors.lastname: Guo
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.
authors.forename: Y
authors.initials: Y
authors.lastname: Sun
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Imaging Diagnosis and Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: L
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: A-H
authors.initials: AH
authors.lastname: Lin
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: M-S
authors.initials: MS
authors.lastname: Zeng
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: T-B
authors.initials: TB
authors.lastname: Kang
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: W-H
authors.initials: WH
authors.lastname: Jia
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Molecular Diagnostics, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Shao
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Nasopharyngeal Cancer, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: H-Q
authors.initials: HQ
authors.lastname: Mai
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.
authors.forename: J
authors.initials: J
authors.lastname: Ma
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D009336:Necrosis / Q000000981:diagnostic imaging*; D011832:Radiation Injuries / Q000000981:diagnostic imaging*; D011859:Radiography; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology*; D016896:Treatment Outcome