Comparison of radiological and clinical features of temporal lobe necrosis in nasopharyngeal carcinoma patients treated with 2D radiotherapy or intensity-modulated radiotherapy.
Comparison of radiological and clinical features of temporal lobe necrosis in nasopharyngeal carcinoma patients treated with 2D radiotherapy or intensity-modulated radiotherapy.
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鼻咽癌二维放疗与调强放疗颞叶坏死影像学及临床特征比较
DOI：
10.1038/bjc.2014.243
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发表时间：
2014-05-27
影响因子：
8.8
通讯作者：
Ma, J.
中科院分区：
文献类型：
--
作者：
Mao, Y-P;Zhou, G-Q;Liu, L-Z;Guo, R.;Sun, Y.;Li, L.;Lin, A-H;Zeng, M-S;Kang, T-B;Jia, W-H;Shao, J-Y;Mai, H-Q;Ma, J.
背景：比较鼻咽癌（nasopharyngeal carcinoma，NPC）患者接受二维适形放疗（two-dimensional radiation，2D-RT）和调强适形放疗（intensity modulated radiation，IMRT）后颞叶坏死（temporal lobe necrosis，TLN）的影像学和临床特点（72名患者，128个颞叶）或IMRT（36名患者，50个肺叶），并发展为放射诱导的、MRI证实的TLN。白质病变（WML）、对比增强病变、囊肿和局部肿块效应分别为128/128和48/50（P= 0.078），123/128 vs 47/50在2D-RT和IMRT组中，10/128对1/50（P= 0.185）和57/128对13/50（P= 0.023）颞叶分别为10/50（P= 0.688）。2D-RT组的WML范围更广（P< 0.001）。2D-RT组增强病灶的最大直径较大（P< 0.001），且有远离鼻咽部的趋势。WML和增强对囊肿发育没有影响（均P= 1）。局部肿块效应总是伴随着对比增强的病变（P= 0.024），但与WML或囊肿无关（分别为P= 0.523和0.341）。两组患者的临床特征无显著差异（P> 0.05），而严重虚弱的发生率差异无显著性（18.1%vs5.6%，P= 0.077）。结论：IMRT诱导的TLN较2D-RT诱导的TLN广泛程度低，程度轻，但两者具有相似的临床特征。
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.
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影响因子：
19.7
作者：
Wang, Yi-Xiang J.;King, Ann D.;Ahuja, Anil T.
通讯作者：
Ahuja, Anil T.
影响因子：
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作者：
Li, Wen-Fei;Sun, Ying;Ma, Jun
通讯作者：
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DOI：
10.1016/s0360-3016(03)00075-0
发表时间：
2003-05-01
影响因子：
7
作者：
Kam, MKM;Chau, RMC;Teo, PML
通讯作者：
Teo, PML
影响因子：
3.9
作者：
Rogers, L. R.;Gutierrez, J.;Jain, R.
通讯作者：
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