Radiation induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: a review of new avenues in its management.
Radiation induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: a review of new avenues in its management.
复制标题
放射诱发鼻咽癌患者颞叶坏死：治疗新途径的回顾。
DOI：
10.1186/1748-717x-6-128
复制
发表时间：
2011-09-30
期刊：
影响因子：
--
通讯作者：
Wu G
中科院分区：
文献类型：
--
作者：
Chen J;Dassarath M;Yin Z;Liu H;Yang K;Wu G
摘要颞叶坏死(TLN)是鼻咽癌患者放疗后最严重的晚期并发症。双侧颞叶不可避免地被包围在辐射场中，因此容易发生辐射引起的坏死。随着三维适形调强放射治疗(IMRT)在鼻咽癌治疗中的广泛应用，TLN的发病率逐渐下降。然而，由于其丧失能力的特点以及在临床和放射学上面临的与恶性肿瘤鉴别的困难，它仍然具有重要的意义。在这篇综述中，我们重点介绍了不同成像方式和治疗方案的演变。FDG PET、SPECT和磁光谱仪是被考虑的最新成像工具。在治疗方面，Bevacizumab仍然是最新的有希望的突破，因为它能够逆转发病机制，而不同于传统的治疗方案，包括大剂量的类固醇、抗凝剂、维生素、高压氧和手术。
Temporal lobe necrosis (TLN) is the most debilitating late-stage complication after radiation therapy in patients with nasopharyngeal cancer (NPC). The bilateral temporal lobes are inevitably encompassed in the radiation field and are thus prone to radiation induced necrosis. The wide use of 3D conformal and intensity-modulated radiation therapy (IMRT) in the treatment of NPC has led to a dwindling incidence of TLN. Yet, it still holds great significance due to its incapacitating feature and the difficulties faced clinically and radiologically in distinguishing it from a malignancy. In this review, we highlight the evolution of different imaging modalities and therapeutic options. FDG PET, SPECT and Magnetic Spectroscopy are among the latest imaging tools that have been considered. In terms of treatment, Bevacizumab remains the latest promising breakthrough due to its ability to reverse the pathogenesis unlike conventional treatment options including large doses of steroids, anticoagulants, vitamins, hyperbaric oxygen and surgery.