32 Cases Of Clinical Analysis Of Radiation-Induced Temporal Lobe Injury After Intensity-Modulated Radiotherapy In Patients With Nasopharyngeal Carcinoma

Objective:Our purpose is to study the clinical characteristics and outcomes of patients with radiation-induced temporal lobe injury(TLI)after Intensity-Modulaed Radiotherapy(IMRT)in NPC patients.Methods:Between March 2005 and January 2012,a total of 260 patients with newly diagnosed,biopsy-proven non-metastatic NPC patients who were included in the study.The clinical data of 260 patients with NPC were retrospectively analyzed,and the clinical features of TLI after IMRT were summarized.Results:32 of 260 patients had radiation-induced temporal lobe injury.25 patients withTLI are located lesions.According to the MRI images,type 2 have 28 cases,type 1 in 4 cases.TLI simultaneously or successively has a total of 7 cases.Radiological temporal lobe injury was associated with T stage,chemotherapy,and temporal lobe maximal dose(Dmax),and the peak period is in four years after radiotherapy.8 patients have typical clinical manifestations,such as memory loss,multi-lingual and(or)increased intracranial pressure,and 24 patients without clinical symptoms.Only 3 patients treatwith glucocorticoid and anti edema.Until May 2015,only 1 patient died of hernia cerebri.Conclusion:Compared with Conventional Two-Dimensional Radiotherapy,TLI after IMRT happened higher,but TLI often occur on the single side,clinical symptoms was not typical,Magnetic resonance(MR)imaging results is not seriousand has a tendency to get better.Intensity modulated radiotherapy(IMRT)Play an important roletoprotection of the temporal lobe in the treatment of nasopharyngeal carcinoma(NPC).