口咽鳞癌患者因辐射导致的咽部坏死和颈椎骨质增生。

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-11-08 DOI:10.1002/hed.27991

Diana S. Shaari, Danielle A. Kapustin, Michelle Yoon, Samuel J. Rubin, Azita Khorsandi, Ricardo J. Ramirez, Michael Schiff, Mark L. Urken

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引用次数: 0

摘要

背景：在治疗头颈癌（HNC）时，放疗加化疗或不加化疗通常被用作手术的辅助或替代手段。在极少数情况下，放射引起的副作用，如咽后壁坏死、瘘管形成和骨坏死（ORN）可导致颈椎（C-spine）出现危险的并发症：我们对 HNC 的 C 型脊柱 ORN 进行了文献综述，并报告了四例口咽癌治疗后的新增病例：结果：我们发现了 26 例 HNC 放射治疗后出现 C 型脊柱 ORN 的病例。在我院的四例病例中，两例采用手术治疗，两例采用保守治疗。两名患者能够恢复口服。中位诊断时间为放疗结束后121.5个月（22-194个月）：结论：放射治疗的晚期并发症可能是毁灭性的，严重限制患者的功能状态和生活质量。脊柱 ORN 与总放射剂量有关，应将其作为一种罕见但严重的副作用与患者讨论。

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Radiation-Induced Pharyngeal Necrosis and Cervical Spine Osteoradionecrosis in Patients With Oropharyngeal Squamous Cell Carcinoma

Background

Radiation therapy with or without chemotherapy is commonly used as an adjunct or alternative to surgery for treating head and neck cancer (HNC). In rare cases, radiation-induced side effects such as posterior pharyngeal wall necrosis, fistula formation, and osteoradionecrosis (ORN) can lead to dangerous complications of the cervical spine (C-spine).

Methods

We conducted a literature review on C-spine ORN in HNC, and we reported four additional cases following the treatment of oropharyngeal carcinoma.

Results

We identified 26 reported cases of C-spine ORN following radiation for HNC. Of the four cases from our institution, two were treated with surgical management and two with conservative measures. Two patients were able to resume oral intake. The median time to diagnosis was 121.5 (range: 22–194) months after completion of radiation.

Conclusion

Late complications of radiation can be devastating, severely limiting functional status and quality of life. C-spine ORN is related to total radiation dose and should be discussed with patients as a rare but serious side-effect.

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.