鼻咽癌放疗后放射性脑病24例报告

RADIATION ENCEPHALOPATHY CAUSED BY RADIOTHERAPY FOR PATIENTS WITH NASOPHARYNGEAL CARCINOMA——A REPORT OF 24 CASES

本文报告经CT扫描诊断的鼻咽癌放疗后放射性脑病24例,首程放疗时平均年龄47.7岁。9例在出现脑病症状之前已对原发灶行再次放疗。脑病平均潜伏期为首程放疗后40个月、再次放疗后16个月。脑病为单侧性12例、双侧性12例(一侧较显著7例),主要癌灶与显著的脑病同侧者占72.2％(13/18例)。临床表现:无症状8例;神经官能症候群样模糊症状5例,伴有颞叶损害症状2例、伴单瘫1例;广泛脑实质损害8例。药治有效6例均为水肿期,囊性期1例无效。本文就本组资料对放射性脑病的发病机制进行讨论。

24 Cases of CT scan proven radiation encephalopath (RE) c-aused by radiotherapy for patients with nasopharyngeal carcinoma are reported. At the first course of radiotherapy their average age was 47.7y.9 cases .underwent the second course before the o-nset of RE symptoms. The mean latent period was 40 months from the end of the first course and 16 months from that of the second one. On CT scans, RE was unilateral in 12 cases, and bilateral in 12 ( one side showing dominant in 7 ) . Main cancer foci and d-ominant RE lesions were ipsilate-ral in 72.2% ( 13/18 ) . Clinical features; 8 cases were a-symptomatic} 5 manifested vague neurotic symptoms.Temporal lobe damage symptoms and monoplegia were seen in 2 and 1 respectiv - ely. 8 manifested extensive cerebral dysfunction. Management with medicine was effective in 6 cases during edema stage and not inl during liquefied stage. The pathogenic mechanism of RE were discussed according to the data of our group.