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鼻咽癌放化疗期间颅底再生:一例报告

Skull Base Regeneration During Treatment With Chemoradiation for Nasopharyngeal Carcinoma: A Case Report.

作者信息

Moyer Kelly F, Maxwell Jessica H, Lumley Catherine, Manning JoAnn C, Gutt Ruchika

机构信息

University of Maryland School of Medicine, Baltimore.

Georgetown University School of Medicine Washington, DC.

出版信息

Fed Pract. 2022 May;39(Suppl 2):S26-S30. doi: 10.12788/fp.0254. Epub 2022 May 9.

Abstract

BACKGROUND

Advanced cases of nasopharyngal carcinoma can present with skull base invasion. Treatment of these advanced cases with radiotherapy poses a challenge given proximity of tumor to critical neural structures as well as concern that a skull base defect and associated complications could develop with tumor regression.

CASE PRESENTATION

A 34-year-old male patient presented with a 7-cm nasopharyngeal tumor invading the skull base with destruction of the clivus and intracranial extension. He underwent a course of definitive chemoradiation, requiring use of adaptive radiotherapy, that resulted in complete tumor regression and is free of disease 5 years posttreatment. Imaging done during treatment demonstrated that significant regeneration of bone occurred simultaneously with tumor regression.

CONCLUSIONS

This case demonstrates that it is possible for bony regeneration to occur simultaneously with tumor regression in a patient with skull base invasion by tumor, precluding the need for neurosurgical intervention.

摘要

背景

晚期鼻咽癌可出现颅底侵犯。鉴于肿瘤与关键神经结构相邻,以及担心随着肿瘤消退可能会出现颅底缺损和相关并发症,对这些晚期病例进行放射治疗具有挑战性。

病例介绍

一名34岁男性患者,患有一个7厘米的鼻咽肿瘤,侵犯颅底,斜坡破坏并向颅内扩展。他接受了一个疗程的确定性放化疗,需要使用自适应放疗,结果肿瘤完全消退,治疗后5年无疾病。治疗期间进行的影像学检查表明,骨的显著再生与肿瘤消退同时发生。

结论

该病例表明,肿瘤侵犯颅底的患者骨再生有可能与肿瘤消退同时发生,从而无需神经外科干预。

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Nasopharyngeal carcinoma: posttreatment changes of imaging findings.鼻咽癌:影像学表现的治疗后改变
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本文引用的文献

1
Adaptive radiotherapy for head and neck cancer.头颈部癌的自适应放射治疗。
Cancers Head Neck. 2020 Jan 9;5:1. doi: 10.1186/s41199-019-0046-z. eCollection 2020.
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Nasopharyngeal carcinoma.鼻咽癌。
Lancet. 2019 Jul 6;394(10192):64-80. doi: 10.1016/S0140-6736(19)30956-0. Epub 2019 Jun 6.
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Human papillomavirus and nasopharyngeal cancer.人乳头瘤病毒与鼻咽癌
Head Neck. 2018 Apr;40(4):696-706. doi: 10.1002/hed.24978. Epub 2018 Jan 11.

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