Jang Joanne W, Chan Annie W
Department of Radiation Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Adv Otorhinolaryngol. 2013;74:163-73. doi: 10.1159/000342293. Epub 2012 Dec 18.
Radiotherapy is an important treatment approach for a variety of benign and malignant skull base tumors. For patients with malignant skull base tumors, radiation therapy is usually given with surgery and chemotherapy. While patient- and tumor-specific factors can affect the risk of radiation-related complications, surgery and chemotherapy also play a large causal role. As surgery and chemotherapy can lower the radiation dose tolerance of the normal tissues in the skull base, a multidisciplinary team approach is necessary in the initial treatment decision-making process. Radiation can delay wound healing and increase complications after reconstructive surgery, and so surgical planning between surgeons and radiation oncologists is critical to ensure the successful repair. In this article, we will discuss the etiology, risk factors and management of osteonecrosis and sinonasal-cutaneous fistula, the two major complications after multimodality treatment of skull base tumors. Careful consideration of specific tumor-, patient- and treatment-related factors in a multidisciplinary manner is vital in minimizing these complications.
放射治疗是多种良性和恶性颅底肿瘤的重要治疗方法。对于恶性颅底肿瘤患者，放射治疗通常与手术和化疗联合使用。虽然患者和肿瘤的特定因素会影响放疗相关并发症的风险，但手术和化疗也起着很大的因果作用。由于手术和化疗会降低颅底正常组织的放射剂量耐受性，因此在初始治疗决策过程中采用多学科团队方法是必要的。放疗会延迟伤口愈合并增加重建手术后的并发症，因此外科医生和放射肿瘤学家之间的手术规划对于确保成功修复至关重要。在本文中，我们将讨论颅底肿瘤多模态治疗后两种主要并发症——骨坏死和鼻-皮肤瘘的病因、危险因素及管理。以多学科方式仔细考虑特定的肿瘤、患者和治疗相关因素对于将这些并发症降至最低至关重要。
