Surgical management of radiation-induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: Report of 14 cases
Yong-gao Mou MD, PhD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
The first 2 authors contributed equally to this work.
Search for more papers by this authorKe Sai MD, PhD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
The first 2 authors contributed equally to this work.
Search for more papers by this authorZhen-ning Wang MD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
Search for more papers by this authorXiang-heng Zhang MD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
Search for more papers by this authorYan-chun Lu MD, PhD
State Key Laboratory of Oncology in South China, Guangzhou, China
Imaging and Minimally Invasive Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou, China
Search for more papers by this authorDa-nian Wei MD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
Search for more papers by this authorQun-ying Yang MD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
Search for more papers by this authorCorresponding Author
Zhong-ping Chen MD, PhD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaSearch for more papers by this authorYong-gao Mou MD, PhD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
The first 2 authors contributed equally to this work.
Search for more papers by this authorKe Sai MD, PhD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
The first 2 authors contributed equally to this work.
Search for more papers by this authorZhen-ning Wang MD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
Search for more papers by this authorXiang-heng Zhang MD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
Search for more papers by this authorYan-chun Lu MD, PhD
State Key Laboratory of Oncology in South China, Guangzhou, China
Imaging and Minimally Invasive Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou, China
Search for more papers by this authorDa-nian Wei MD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
Search for more papers by this authorQun-ying Yang MD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
Search for more papers by this authorCorresponding Author
Zhong-ping Chen MD, PhD
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, China
State Key Laboratory of Oncology in South China, Guangzhou, China
Department of Neurosurgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaSearch for more papers by this authorAbstract
Background
Radiation-induced temporal lobe necrosis is a rare and serious late complication in irradiated patients with nasopharyngeal carcinoma (NPC). Treatment of radiation-induced temporal lobe necrosis with surgery has been seldom thoroughly investigated.
Methods
We retrospectively analyzed the clinical data of 14 patients with radiation-induced temporal lobe necrosis treated with surgical intervention.
Results
Radiation-induced temporal lobe necrosis presented as obvious cystic formation or as heterogeneous enhanced nodule on MRI. Among 3 patients with 18F-fluorodeoxyglucose (18F-FDG) PET-CT scan, increased uptake of 18F-FDG was observed in 2 cases. Four patients were anesthestized nasotracheally and 1 was through tracheostomy during surgery because of other radiation complications, including trismus and skull base osteoradionecrosis. The temporal approach was applied in all cases, with the removal of bone flap in 11 patients. During follow-up, 1 patient died of exhaustion.
Conclusions
Surgery benefits selected patients with NPC with radiation-induced temporal lobe necrosis. The goals of surgery are to relieve the increased intracranial pressure and to establish the accurate diagnosis. © 2010 Wiley Periodicals, Inc. Head Neck, 2010
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