Central nervous system infection in patients with postirradiated nasopharyngeal carcinoma: a case-controlled study
Autor: | Jin-Ching Lin, Rong-San Jiang, Kai-Li Liang, Chung-Han Hsin, Jiun-Yih Shiao, Yu-Jung Chiu, Mao-Chang Su |
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Rok vydání: | 2009 |
Předmět: |
Oncology
Adult Central Nervous System Male medicine.medical_specialty Epidural abscess Osteoradionecrosis Biopsy Taiwan Cavernous sinus thrombosis Gastroenterology Central Nervous System Infections Risk Factors Internal medicine Immunology and Allergy Medicine Humans Brain abscess Aged Neoplasm Staging Retrospective Studies business.industry Incidence Carcinoma Retrospective cohort study Dose-Response Relationship Radiation Endoscopy Nasopharyngeal Neoplasms General Medicine Middle Aged medicine.disease Prognosis Otitis Otorhinolaryngology Nasopharyngeal carcinoma Female medicine.symptom business Tomography X-Ray Computed Meningitis |
Zdroj: | American journal of rhinologyallergy. 23(4) |
ISSN: | 1945-8924 |
Popis: | Background It has been assumed that postirradiated nasopharyngeal carcinoma (NPC) patients are prone to central nervous system (CNS) infection. Objective The purpose of this study was to better understand this clinical entity. Methods From September 1989 to May 2006, we conducted a retrospective study of 18 postirradiated NPC patients with CNS infection including brain abscess, cavernous sinus thrombosis, epidural abscess, and meningitis in our institute. During the same period, 18 NPC patients without CNS infection who were matched for tumor stage, age, and gender with the study group were randomly selected from the cancer registry at our hospital and enrolled as the control group. All medical records of these patients were evaluated. Results The local tumor relapse rate, nasopharyngeal radiotherapy dose, and skull base osteoradionecrosis were all significantly higher in patients with CNS infection (p = 0.003, 0.011, and 0.001, respectively). Although the incidences of otitis media and chronic rhinosinusitis were higher in patients with CNS infection, there were no significant differences between the two groups (p = 0.469 and 0.568, respectively). The in-hospital mortality was 61.1%, and the overall mortality of CNS infection was 83.3%. There was a significant difference in overall survival rate between the two groups (p = 0.001). Conclusions Postirradiated NPC patients with skull base osteoradionecrosis are prone to have CNS infection. CNS infection is an adverse prognostic factor in postirradiated NPC patients. |
Databáze: | OpenAIRE |
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