Hua Yi-Jun, Chen Ming-Yuan, Qian Chao-Nan, Hong Ming-Huang, Zhao Chong, Guo Ling, Guo Xiang, Cao Kao-Jia
State Key Laboratory of Oncology in Southern China, Guangzhou, China.
Head Neck. 2009 Jun;31(6):807-12. doi: 10.1002/hed.21036.
Radiation-induced nasopharyngeal necrosis is a consequential late effect in the patients with nasopharyngeal carcinoma (NPC). Patients with NPC who have been treated with high-dose radiotherapy are at risk of developing postradiation nasopharyngeal necrosis (PRNN). However, the analysis of PRNN with a significant cohort of patients has not been reported in English-language literature. In this study, we aimed to evaluate PRNN in 28 patients with NPC.
From June 2006 to December 2007, 28 patients were diagnosed with PRNN with pathologic evidence. Surgical procedure of endoscopy-guided debridement and systemic anti-inflammatory treatments were conducted for the patients. Their clinical features, treatment procedures, and outcomes were analyzed retrospectively.
Clinical symptoms such as foul odor and headache were alleviated in all, 8 patients were cured of their PRNN, 9 patients with exposed internal carotid artery died of sudden nasopharyngeal massive bleeding, and 3 patients died of exhaustion (cachexia).
PRNN is an important consequential late effect of radiotherapy in the patients with NPC. Internal carotid artery erosion is a severe situation and acts as an independent prognostic factor for the patients. Diagnosis of PRNN could be made after ruling out the persistent-recurrent NPC proven by pathologic examination. Surgery is effective for improving the quality of life and for curing PRNN.
放射性鼻咽坏死是鼻咽癌（NPC）患者放疗后的一种严重晚期并发症。接受高剂量放疗的NPC患者有发生放疗后鼻咽坏死（PRNN）的风险。然而，英文文献中尚未有对大量PRNN患者进行分析的报道。在本研究中，我们旨在评估28例NPC患者的PRNN情况。
2006年6月至2007年12月，28例经病理证实诊断为PRNN的患者接受了内镜引导下清创手术及全身抗炎治疗。对其临床特征、治疗过程及结果进行回顾性分析。
所有患者的异味和头痛等临床症状均得到缓解，8例PRNN患者治愈，9例颈内动脉暴露患者死于鼻咽部大出血，3例患者死于衰竭（恶病质）。
PRNN是NPC患者放疗后的一种重要晚期并发症。颈内动脉侵蚀是一种严重情况，是患者的独立预后因素。排除经病理检查证实的持续性复发性NPC后可诊断PRNN。手术对于改善生活质量及治愈PRNN有效。
