Discussion on the surgical methods of radiation-induced encephalopathy mainly featured with cystic change in the temporal lobe

Objective To assess the clinical outcomes of various surgical methods of radiation-induced encephalopathy (REP) mainly featured with cystic change in the temporal lobe. Methods A retrospective study was conducted on the clinical data of 56 patients with REP mainly featured with cystic change in the temporal lobe who underwent surgery at Department of Neurosurgrey, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University from January 2010 to December 2016. Among them, 24 peoples underwent merely lesionectomy (control group), while the other 32 peoples underwent lesionectomy and cistern opening (experimental group). According to the postoperative outcome, KPS (Karnofsky performance status) score, the volume of lesion on MRI and clinical follow-up , we compared the surgical effect between the 2 groups. Results In control group, 7 patients (29.2%) reported relief of chief complaint, while 23 patients (71.9%) in experimental group had relief. The difference was statistically significant (P<0.05). The KPS score was 70.13±19.10 in control group and 84.16±13.47 in experimental group, which had significant difference (P<0.05). The volume of lesion post surgery was (32.35±20.85)cm3 in group and (13.31±6.44)cm3 in experimental group, which had statistical difference (P<0.05). The follow-up data showed that the readmission rate in experimental group (18.7%, 6/32) was lower than that in control group (75.0%, 18/24). which had significant difference(P<0.05). Conclusion For REP mainly featured with temporal lobe cyst, the surgical operation should include further dissection of cisterna ambiens and cisterna interpeduncularis in addition to merely lesionectomy, which could help prevent the formation of isolated cyst cavity with space-occupying effect and achieve better therapeutic results. Key words: Temporal lobe; Radiation encephalopathy; Neurosurgical procedures; Treatment outcome