Abstract：
PURPOSE:To investigate the incidence and clinical features of post-radiation nasopharyngeal necrosis (PRNN), and effectiveness of surgical intervention for its treatment. MATERIALS AND METHODS:Retrospectively, we reviewed 380 NPC patients who underwent high dose radiotherapy (RT) (single RT in 355 and re-RT in 25) from January 2008 till December 2017 at the authors' institute, among who 22 developed Grade ≥ 3 PRNN. The management of PRNN was discussed through weekly multidisciplinary head and neck oncology conference, and surgical debridement was performed when feasible. RESULTS:The incidence of PRNN was significantly higher following re-RT than in single RT (11/355, 3.1% vs. 11/25, 44.0%, p < 0.001). The PRNN patients in single RT group tended to be older and had more advanced initial tumor extents. The intervals from the latest RT start till PRNN assignment were similar between groups (7.3 vs. 6.6 months, p = 0.140). Nineteen patients underwent surgical debridement: two open; and 17 endoscopic approach, respectively. Endoscopic mucosal reconstruction was performed in eight patients. Resolution of PRNN was achieved in 11 patients (64.7%). The rates of 3-year overall survivals (OS) from the initial RT, latest RT (adjusting re-RT), and PRNN assignment were 84.4%, 70.9%, and 54.7%, respectively. Eight patients (36.4%) succumbed to death: NPC progression in three (13.6%); evidently PRNN-related events in two (9.1%), probably PRNN-related events in two (9.1%); and inter-current death in one (4.5%), respectively. CONCLUSION:PRNN needs close collaboration among head and neck oncologists and could be successfully recovered, without compromising survival, following timely surgical intervention.
journal_name
Oral Oncoljournal_title
Oral oncologyauthors
Yang K,Ahn YC,Nam H,Hong SD,Oh D,Noh JMdoi
10.1016/j.oraloncology.2021.105180subject
Has Abstractpub_date
2021-01-23 00:00:00pages
105180eissn
1368-8375issn
1879-0593pii
S1368-8375(21)00003-8journal_volume
114pub_type
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