摘要
目的探讨一期双侧颞叶病灶切除术治疗鼻咽癌放疗后双侧严重放射性额叶损伤的疗效及安全性。方法中山大学孙逸仙纪念医院神经外科自2013年1月至2017年12月采用一期双侧额叶病灶切除术治疗鼻咽癌放疗后双侧严重放射性颞叶损伤患者12例,回顾性分析患者的临床资料,比较患者术前、术后2周Kamofsky功能状态评分(KPS)变化,记录手术相关并发症和死亡情况,比较患者术前、术后3个月头颅影像学图像以评估额叶病灶变化。结果12例(100%)患者术后KPS评分均得到改善,与术前KPS评分比较差异有统计学意义(P<0.05)。2例患者术后出现肺部感染,1例患者出现切口愈合不良,1例患者出现颅内感染,对症处理后均康复出院。12例患者术后均无新发神经系统症状。随访期间12例患者术后头颅MRI检査显示病灶被完整切除,脑白质病变减轻或完全消退。结论一期双侧颞叶病灶切除术治疗鼻咽癌放疗后双侧严重放射性颞叶损伤是安全可行的。
Objective To observe the safety and efficacy of one-stage bilateral temporal lobe lesions resection in patients with severe bilateral radiation-induced temporal lobe injury after radiotherapy for nasopharyngeal carcinoma.Methods Clinical data of 12 patients with severe bilateral radiation-induced temporal lobe injury after radiotherapy for nasopharyngeal carcinoma underwent one-stage bilateral temporal lobe lesions resection in our hospital from January 2013 to December 2017 were retrospectively analyzed.Kamofsky Performance Scale(KPS)scores were used as predictors of surgical outcomes before and two weeks after surgery.Imaging changes of radiation-induced brain injury lesions after surgery before and 3 months after surgery,surgical-related complications,and death were observed.Results All 12 patients(100%)had improved postoperative KPS scores,which showed significant difference as compared with the preoperative KPS scores(P<0.05).Two patients had pulmonary infection after operation,one patient had poor wound healing,and one patient had intracranial infection;all of them recovered after expectant treatment.None of the 12 patients had new neurological symptoms after surgery.During the follow-up period,the postoperative cranial MR imaging showed that the lesions were completely removed,and the leukoencephalopathy was alleviated or completely subsided.Conclusion One-stage bilateral temporal lobe lesions resection is feasible for bilateral radiation-induced temporal lobe injury after radiotherapy for nasopharyngeal carcinoma.
作者
欧阳乐平
刘家豪
何明亮
谢琳
黄佐於
刘安民
Ouyang Leping;Liu Jiahao;He Mingliang;Xie Lin;Huang Zuoyu;Liu Anmin(Department of Neurosurgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510000,China)
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2020年第3期273-276,共4页
Chinese Journal of Neuromedicine
基金
广州市科技计划项目(201803010045)。
关键词
放射性脑损伤
一期双侧病灶切除术
疗效
Radiation-induced brain injury
One-stage bilateral temporal lobe lesion resection
Efficacy
作者简介
通信作者:刘安民,Email:liuanmin@mail.sysu.edu.cn。
