| Yang Yuhua,Li Honghong,Huang Jialin,Xie Jiatian,Li Shaojian,Tang Yamei.Clinical characteristics of radiation-induced brainstem injury after radiotherapy in patients with head and neck tumors[J].Chinese Journal of Radiological Medicine and Protection,2022,42(3):194-197 |
| Clinical characteristics of radiation-induced brainstem injury after radiotherapy in patients with head and neck tumors |
| Received:September 26, 2021 |
| DOI：10.3760/cma.j.cn112271-20210926-00393 |
| KeyWords:Radiation-induced brain injury Clinical characteristics Clinical outcome |
| FundProject:国家杰出青年科学基金项目（81925031）；国家自然科学基金国际合作与交流项目（81820108026）；广州市科技计划项目（202007030001）；国家自然科学基金项目（82003389）；中国博士后科学基金（2020M683095） |
| Author Name | Affiliation | E-mail | | Yang Yuhua | Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China | | | Li Honghong | Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China | | | Huang Jialin | Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China | | | Xie Jiatian | Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China | | | Li Shaojian | Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China | | | Tang Yamei | Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China | tangym@mail.sysu.edu.cn |
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| Abstract:: |
| Objective To provide insight into the clinical characteristics, therapy and prognosis of patients with radiation-induced brainstem injury after radiotherapy. Methods From August 2013 to September 2021, 13 patients with radiation-induced brainstem injury were included in this study at Sun Yat-sen Memorial Hospital, and the general information and strategy of radiotherapy were collected. A retrospective analysis was adopted to investigate the clinical and radiological characteristics, treatment and clinical outcomes. Results There were 13 cases in total, including 4 females and 9 males. The onset age of enrolled patients ranged from 29 to 66 years with an average of (48.15±10.23) years. The median dose targeted at tumor area was 70 Gy with in 33 fractions. The median interval between radiotherapy and the diagnosis of radiation-induced brainstem injury was 24 months. The common clinical manifestations included dysphagia, bucking dysarthria, dizziness and problem with balance. The MRI radiological features were hypointense on T1WI, hyperintense on T2WI, and irregularly enhanced with contrast. The median follow-up was 45 months. Seven cases got improvements, while 3 had no obvious efficacy and 3 cases died. No significant differences in prognosis were observed between those received traditional glucocorticoid and those received bevacizumab treatment(P=0.079). The common symptoms of radiation-induced brainstem injury were symptoms of posterior cranial nerves injury and ataxia. Lesions mostly happened in pons and medulla, with hypointense on T1WI and hyperintense on T2WI. Half of the patients have improved after treatment. There was no significant difference in prognosis between glucocorticoid and bevacizumab treatment. |
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