Document Detail

Results of excision of cerebral radionecrosis: experience in patients treated with radiation therapy for nasopharyngeal carcinoma.
MedLine Citation:
PMID:  20151776     Owner:  NLM     Status:  MEDLINE    
OBJECT: In theory, the purpose of the treatment of cerebral radionecrosis (CRN), a nonneoplastic condition, is to minimize loss of brain function by preventing the progression and reversing some of the processes of CRN. In a practical sense, factors for achieving this purpose may include the following: removal of a CRN lesion that is causing mass effect, control of brain edema, prevention of recurrence of CRN lesions, minimization of adverse effects from treatments, and achievement of reasonably long and good-quality survivals. Based on these practical issues, the authors performed a retrospective study to evaluate the results of excision for the treatment of CRN. METHODS: The authors retrospectively reviewed the results of excision of CRN lesions in a group of patients with temporal lobe CRN due to radiotherapy for nasopharyngeal carcinoma. Patients who had undergone surgery at the authors' institution between January 1998 and November 2008 were analyzed. Surgical results were evaluated by assessing postoperative resolution of brain edema, recurrence of temporal lobe CRN, surgery-related complications, and postoperative functional status and survival. RESULTS: Twenty-four patients were included (age range 39-69 years; in 23 patients nasopharyngeal carcinoma was in remission). All patients underwent craniotomy for excision of the contrast-enhancing region. The indications for operation were temporal lobe CRN lesions with a mass-occupying effect beyond the temporal lobe. There were 32 craniotomies in all (mean postoperative follow-up 40 months). It was found that brain edema resolved rapidly postoperatively. The recurrence and reoperation rates were 6.3 and 3.1%, respectively. There were no surgery-related deaths. The median survival was 72 months, and 67% of the patients had a Karnofsky Performance Scale score of > or = 70% at the time of their last follow-up. CONCLUSIONS: In a specific group of patients with CRN of the temporal lobe in whom the CRN lesions were causing a mass-occupying effect beyond the temporal lobe, excision of the contrast-enhancing region was safe and could achieve prompt resolution of brain edema and a low incidence of recurrence of CRN.
Sui-To Wong; Ka-Tai Loo; Kwong-Yui Yam; Wai-Man Hung; Kam-Fuk Fok; Shing-Chau Yuen; Dawson Fong
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  113     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-02     Completed Date:  2010-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  293-300     Citation Subset:  AIM; IM    
Department of Neurosurgery, Tuen Mun Hospital, Tuen Mun, Hong Kong, Special Administrative Region, China.
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MeSH Terms
Brain Edema / etiology,  mortality,  pathology,  radiography
Brain Neoplasms / mortality,  radiography,  radiotherapy*
Combined Modality Therapy
Follow-Up Studies
Intraoperative Complications
Middle Aged
Nasopharyngeal Neoplasms / mortality,  radiography,  radiotherapy*
Neoplasm Recurrence, Local / mortality
Postoperative Complications
Radiation Injuries / mortality,  pathology,  surgery*
Radiotherapy / adverse effects*,  mortality
Retrospective Studies
Survival Analysis
Temporal Lobe / pathology*,  radiography
Tomography, X-Ray Computed

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