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. 2024 Mar 23;9(2):e1200.
doi: 10.1002/lio2.1200. eCollection 2024 Apr.

Characterization of cerebral radiation necrosis following the treatment of sinonasal malignancies

Eric L Wu  1 , Atur Patel  1 , Mary C McGunigal  2 , Stephanie Y Johng  3 , Armin Mortazavi  3 , Ann K Jay  4 , Peter H Ahn  5 , Amjad N Anaizi  6 , Timothy R DeKlotz  1
Affiliations

Characterization of cerebral radiation necrosis following the treatment of sinonasal malignancies

Eric L Wu et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objectives: Our study aims to determine the incidence and potential risk factors for cerebral radiation necrosis (CRN) following treatment of sinonasal malignancies.

Methods: One hundred thirty-two patients diagnosed with sinonasal malignancies over an 18-year period were identified at two institutions. Forty-six patients meeting inclusion criteria and treated with radiation therapy were included for analysis. Demographic and clinical-pathologic characteristics were collected and reviewed. Post-treatment magnetic resonance imaging (MRI) at least 1 year following treatment was reviewed to determine presence or absence of CRN.

Results: CRN was identified on MRI in 8 of 46 patients (17.4%) following radiation treatment. Patients with a history of reirradiation were more likely to develop CRN (50% vs. 10.5%, p < .05). The BEDs of radiation were also higher in CRN patients compared to non-CRN patients, but this difference was not significant (p > .05). CRN patients had a higher proportion of tumors with skull base involvement than non-CRN patients (100% vs. 57.9%, p = .037). Demographics, comorbidities, pathology, primary tumor subsite, chemotherapy use, and stage of disease demonstrated no significant increase in risk of CRN.

Conclusions: Reirradiation and tumor skull base involvement were significant risk factors associated with CRN. Higher average total prescribed and BEDs of radiation were seen in the CRN groups, but these differences were not statistically significant. Gender, comorbidities, tumor subsite, tumor location, and treatment type were not significantly different between groups.

Level of evidence: Level 3.

Keywords: Sinonasal malignancies; cerebral radiation necrosis; nose and paranasal sinuses; radiation therapy; sinus cancer.

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Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
Post‐radiation therapy T1‐weighted post‐contrast coronal magnetic resonance imaging of a patient with CRN. Image shows characteristic soap‐bubble lesions (arrow) associated with CRN.
See this image and copyright information in PMC

References

    1. Myers LL, Nussenbaum B, Bradford CR, Teknos TN, Esclamado RM, Wolf GT. Paranasal sinus malignancies: an 18‐year single institution experience. Laryngoscope. 2002;112:1964‐1969. - PubMed
    1. Chong VF, Fan YF, Mukherji SK. Radiation‐induced temporal lobe changes: CT and MR imaging characteristics. AJR Am J Roentgenol. 2000;175:431‐436. - PubMed
    1. Hsu Y‐C, Ho KY, Kuo WR, Wang LF, Lee KW, Huang SL. Cerebral radionecrosis with cystic degeneration following radiotherapy for nasal cavity squamous cell carcinoma: a case report. Kaohsiung J Med Sci. 2004;20:308‐312. - PMC - PubMed
    1. Glass JP, Hwang TL, Leavens ME, Libshitz HI. Cerebral radiation necrosis following treatment of extracranial malignancies. Cancer. 1984;54:1966‐1972. - PubMed
    1. Landry D, Garsa AA, Glastonbury CM. Imaging of cerebral Radionecrosis: collateral damage from head and neck radiation. Neurographics. 2016;6:151‐158.

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