Cancer Centre, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Radiat Oncol. 2011 Sep 30;6:128. doi: 10.1186/1748-717X-6-128.
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.
颞叶坏死（TLN）是鼻咽癌（NPC）患者放射治疗后最具致残性的晚期并发症。双侧颞叶不可避免地包含在放射野内，因此容易发生放射性坏死。3D 适形和调强放疗（IMRT）在 NPC 治疗中的广泛应用，导致 TLN 的发病率下降。然而，由于其致残性特征以及临床上和影像学上鉴别其与恶性肿瘤的困难，它仍然具有重要意义。在这篇综述中，我们强调了不同成像方式和治疗选择的演变。FDG PET、SPECT 和磁共振波谱是最新考虑的成像工具之一。在治疗方面，贝伐单抗是最新的有前途的突破，因为它能够逆转发病机制，而不同于包括大剂量类固醇、抗凝剂、维生素、高压氧和手术在内的传统治疗选择。
