ABSTRACT
Objective To investigate the characteristics of radiation-induced optic neuropathy (RON) in patients with nasopharypgeal carcinoma after radiotherapy,and explore its risk factors.Methods A retrospective study was performed on the clinical data of 22 RON patients with nasopharyngeal carcinoma after radiotherapy,admitted to our hospital from January 1997 to January 2011.Their clinical manifestations,eye examinations and cranial MRI data were concluded.Results Visual deterioration,or even,blindness,was the most common manifestation.RON occurred after the initial radiotherapy in 18 cases,and during the initial radiotherapy in 2 cases.And 2 cases developed RON in re-irradiation for recurrences.Blindness developed in 8 eyes,and decreased vision occurred in 27 eyes; 14 patients displayed retinal optic nerve atrophy in the eye examinations.Typical radiological imaging of the skull showed optic nerve enlargement in 30 eyes,optic nerve atrophy in 5 eyes; and the incidence of optic neuropathy was high when radiation dose was over 70 Gy.Conclusion RON may occur in nasopharyngeal carcinoma patients following radiotherapy,having vision disorders,visual field changes,abnormal visual evoked potential and typical cranial imaging performances; the occurrence of RON may be correlated with radiation field and radiation dose; routine eye and imaging examination is of great significance.
ABSTRACT
Objective To investigate the clinical characteristics and imaging features of radiation-induced hypopituitarism (RIH) in nasopharyngeal carcinoma (NPC) patients after radiotherapy.Methods Retrospective study was performed on the clinical data of 9 NPC patients (7 males and 2 females), diagnosed as RIH after radiotherapy in our hospital from 2000 to 2009; their clinical manifestations, anterior-pituitary hormone levels, cranial MRI features and follow-up results were analyzed. Results The interval between complications after radiotherapy and diagnoses of RIH varied from 10 months to 15 years.Multiple hormone deficits appeared in 5 patients; thyrotropin deficiency and hyperprolactinemia were the most common complications, followed by adrenocorticotropic hormone (ACTH) insufficiency.Typical radiological imaging of the pituitary gland displayed partially empty sella and atrophy of pituitaly gland,which was demonstrated in 2 patients.Five patients got improvement after hormone replacement therapy. Conclusion Radiation-induced hypopituitarism may occur in NPC patients; most patients are subclinical without typical radiological alterations in MRI for pituitary.Routine evaluation of adenohypophysis function is necessary for early detection of hormone deficiency and early hormone replacement treatment.
ABSTRACT
Objective To investigate the clinical and imaging characteristics of epilepsy in radiation encephalopathy (RE) patients after nasopharyngeal carcinoma (NPC) radiotherapy.Methods One hundred and twelve RE patients after NPC radiotherapy,admitted to our hospital from February 2005 to December 2010,were chosen in our study; these patients were divided into epilepsy group and non-epilepsy group according to the appearance of epilepsy; their clinical and cranial MR imaging and EEG data were collected and compared.Results Epilepsy was a common symptom in RE patients after NPC radiotherapy,with an incidence of 15.2％ (17/112); secondary generalized tonic-clonic (SGTC) seizure was the most common type (9/17),followed by simple partial seizure (5/17).Cystic lesions in the temporal lobe under MRI in RE patients with epilepsy were more common as compared with those in RE patients without epilepsy.EEG recorded scattered sharp waves and sharp slow waves in RE patients with/without epilepsy.Nine RE patients with epilepsy achieved seizure-control without using the antiepileptic drugs after treatment of the primary disease.Conclusion SGTC seizure and simple partial seizure are common types in RE patients after NPC radiotherapy,and antiepileptic drugs can control the seizure.