PDF(Pubmed)
Abstract：
Background Despites advances in radiation technology, skull base osteoradionecrosis (ORN) continues to be a rare, devastating, and hard to treat complication of radiotherapy. We present three cases of anterior skull base ORN in a cohort treated with intensity-modulated radiation therapy (IMRT). Case Series Three patients developed anterior skull base ORN after receiving at least one round of IMRT. ORN was diagnosed through either nasal endoscopy or imaging findings. The first was a 59-year-old woman with a sinonasal squamous cell carcinoma. Her chemoradiation history was notable for reirradiation and a high dose of radiation (143.3 Gy). The second was a 55-year-old man with recurrent nasopharyngeal carcinoma, whose history was notable for a high dose of radiation (∼140 Gy) and for being reirradiated. The final patient was a 37-year-old woman with an unremarkable history who received radiotherapy (65.0 Gy) for an esthesioneuroblastoma. One patient was asymptomatic and did not receive ORN-specific therapy. The other two were treated with a combination of medical and surgical intervention with successful short-term outcomes (no evidence of infection). Conclusion Anterior skull base ORN can be treated through conservative and surgical means to achieve successful short-term outcomes. Further investigation of long-term outcomes is warranted.
摘要：
背景技术人们对辐射技术的进步不屑一顾,颅底放射性骨坏死（ORN）仍然是罕见的，毁灭性的,放疗并发症难以治疗。我们在接受调强放射治疗（IMRT）治疗的队列中介绍了三例前颅底ORN。病例系列三名患者在接受至少一轮IMRT后出现前颅底ORN。通过鼻内窥镜检查或影像学发现诊断ORN。第一个是一名59岁的女性，患有鼻窦鳞状细胞癌。她的放化疗史值得注意的是再辐射和高剂量辐射（143.3Gy）。第二位是一名55岁的复发性鼻咽癌患者，其历史以高剂量辐射(~140Gy)和再照射而著称。最后一名患者是一名37岁的女性，其病史不明显，接受了放疗（65.0Gy）治疗神经母细胞瘤。一名患者无症状，未接受ORN特异性治疗。另外2例接受了药物和手术干预的组合治疗，短期结果成功（无感染迹象）。结论前颅底ORN可以通过保守和手术手段进行治疗，以获得成功的短期疗效。有必要对长期结果进行进一步调查。
