Analysis of risk factors of outcomes of radiation induced-brain injury after IMRT in nasopharyngeal carcinoma / 中华放射肿瘤学杂志

ABSTRACT

Objective To explore the risk factors influencing the outcomes of radiation brain injury after intensity-modulated radiotherapy (IMRT) in patients diagnosed with nasopharyngeal carcinoma.Methods Clinical data of 1 300 nasopharyngeal carcinoma patients treated with IMRT in our hospital during 2006 and 2013 were retrospectively analyzed.Fifty-eight patients presented with radiation brain injury after IMRT.MRI data of these patients during 3-24 months follow-up were collected.The clinical efficacy in the treatment of radiation brain injury was evaluated according to RECIST guidelines.Results Forty-six patients with intact follow-up data were enrolled.The median latency of radiation brain injury was 34 months.Patients were divided into the response (CR+PR) and non-response groups.The risk factors influencing the response rate during 10-12 months and 18-24 months were identified and analyzed.Univariate analysis demonstrated that gender,age,smoking history,T stage,and high-intensity treatment exerted no significant effect upon the objective remission rate during these two time intervals periods.Patients treated with gangliosides obtained high response rate.The response rate was 68.8％ in 10-12 months (P=0.000),and 81.8％ in 18-24 months (P=0.008).Multivariate analysis revealed that use of gangliosides was a favorable factor for mitigating radiation brain injury in two time intervals (OR=19.8 and 13.5;P=0.001 and 0.005).Conclusions Use of gangliosides probably accelerates the healing of radiation brain injury,whereas the clinical efficacy remains to be elucidated by prospective clinical trials.