Neurosurgery and prognosis in patients with radiation-induced brain injury after nasopharyngeal carcinoma radiotherapy: a follow-up study

被引:12
作者
Li, Yi [1 ,2 ]
Shi, Xiaolei [1 ,2 ]
Rong, Xiaoming [1 ,2 ]
Peng, Ying [1 ,2 ]
Tang, Yamei [1 ,2 ]
机构
[1] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Neurol, Guangzhou 510275, Guangdong, Peoples R China
[2] Sun Yat Sen Univ, Guangdong Higher Educ Inst, Key Lab Malignant Tumor Gene Regulat & Target The, Guangzhou 510275, Guangdong, Peoples R China
来源
RADIATION ONCOLOGY | 2013年 / 8卷
基金
中国国家自然科学基金;
关键词
Radiotherapy; Nasopharyngeal carcinoma; Radiation-induced brain injury; Neurosurgery; TEMPORAL-LOBE NECROSIS; CANCER;
D O I
10.1186/1748-717X-8-88
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Radiotherapy is the standard radical treatment for nasopharyngeal carcinoma (NPC) and may cause radiation-induced brain injury (RI). Treatment for RI remains a challenge. We conducted this study to investigate the indications of neurosurgery, operation time and prognosis of patients with RI after NPC radiotherapy who underwent neurosurgical management. Methods: This was a follow-up study between January 2005 and July 2011. Fifteen NPC cases of RI who underwent neurosurgery were collected. Brain Magnetic resonance imaging (MRI), surgery and histology were studied. The outcome was assessed by LENT/SOMA scales and modified Rankin scale. Results: Brain lesion resection (86.7%) was more common than decompressive craniotomy (13.3%). According to LENT/SOMA scale before and six months after surgery, 13 of 15, 12 of 15, 14 of 15, and 14 of 15 cases showed improvement at subjective, objective, management and analytic domains, respectively. 12 of 15 patients showed improvement of modified Rankin scale after surgery. Three patients who underwent emergency surgery showed significant improvement (average score increment of 2, 2.7, 2.7, 3 and 2 at LENT/SOMA scale subjective, objective, management, analytic, and modified Rankin scale, respectively), as compared with 12 cases underwent elective surgery (average score increment of 1, 1, 1.4, 1.8 and 1 at LENT SOMA scale subjective, objective, management, analytic, and modified Rankin scale, respectively). Conclusions: Neurosurgery, including brain necrotic tissue resection and decompressive craniotomy, improves the prognosis for RI patients, especially for those with indications of emergency surgery.
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页数:6
相关论文
共 19 条
  • [1] Update on brain tumor imaging
    Cha S.
    [J]. Current Neurology and Neuroscience Reports, 2005, 5 (3) : 169 - 177
  • [2] Radiation induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: a review of new avenues in its management
    Chen, Jing
    Dassarath, Meera
    Yin, Zhongyuan
    Liu, Hongli
    Yang, Kunyu
    Wu, Gang
    [J]. RADIATION ONCOLOGY, 2011, 6
  • [3] NEUROBEHAVIORAL SEQUELAE OF CRANIAL IRRADIATION IN ADULTS - A REVIEW OF RADIATION-INDUCED ENCEPHALOPATHY
    CROSSEN, JR
    GARWOOD, D
    GLATSTEIN, E
    NEUWELT, EA
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 1994, 12 (03) : 627 - 642
  • [4] Temporal lobe necrosis: a dwindling entity in a patient with nasopharyngeal cancer after radiation therapy
    Dassarath, Meera
    Yin, Zhongyuan
    Chen, Jing
    Liu, Hongli
    Yang, Kunyu
    Wu, Gang
    [J]. HEAD & NECK ONCOLOGY, 2011, 3
  • [5] Genc M, 2006, Br J Radiol, V79, pe196, DOI 10.1259/bjr/50789043
  • [6] GLASS JP, 1984, CANCER-AM CANCER SOC, V54, P1966, DOI 10.1002/1097-0142(19841101)54:9<1966::AID-CNCR2820540930>3.0.CO
  • [7] 2-4
  • [8] HO JHC, 1978, INT J RADIAT ONCOL, V4, P183
  • [9] Hsu Ying-Che, 2005, Kaohsiung Journal of Medical Sciences, V21, P452
  • [10] DELAYED RADIATION ENCEPHALOPATHY AFTER RADIOTHERAPY FOR NASOPHARYNGEAL CANCER - A CT STUDY OF 45 CASES
    HU, JQ
    GUAN, YH
    ZHAO, LZ
    XIE, SX
    GUO, Z
    LIANG, ZH
    [J]. JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 1991, 15 (02) : 181 - 187