Cranial neuropathies in advanced nasopharyngeal carcinoma: Neurological recovery after modern radiotherapy and systemic chemotherapy

Autor: James C.H. Chow, Jeffrey C.H. Chan, Elizabeth Y.H. Chuk, Winnie W.Y. Sung, Sarin Kitpanit, K.M. Cheung, Kelvin K.H. Bao, Anthony H.P. Tam, Kam Hung Wong, Chawalit Lertbutsayanukul, T.Y.M. Tsui, Anussara Prayongrat, Chakkapong Chakkabat, Danita Kannarunimit, Daniel H.S. Chung, Anna Lee
Rok vydání: 2021
Předmět:
Zdroj: Radiotherapy and Oncology. 163:221-228
ISSN: 0167-8140
2004-2019
DOI: 10.1016/j.radonc.2021.08.022
Popis: OBJECTIVES Cranial neuropathy is a common presenting symptom of advanced T4 nasopharyngeal carcinoma (NPC). Data on neurological outcomes after modern intensity-modulated radiotherapy (IMRT) and chemotherapy are scarce. MATERIALS AND METHODS Case records of consecutive T4 NPC patients who received definitive IMRT in two tertiary oncology centers in 2004-2019 were reviewed. Patterns of cranial neuropathies at disease presentation were recorded. Time to neurological recovery and the rate of subsequent re-palsy were estimated by the Kaplan-Meier method. Clinical predictors were analyzed using multivariable Cox regression. RESULTS During the study period, 257 T4 NPC patients presented with 504 individual cranial neuropathies. The median time from neuropathy onset to NPC diagnosis was two months (IQR, 1-4 months). Cranial nerves (CN) VI (56.4%), V2 (47.9%), and V3 (29.2%) were most frequently involved. At a median follow-up of 6.4 years, the crude partial and full recovery rates of neuropathies were 111 (22%) and 289 (57.3%), respectively. CN III, IV, and VI had the highest 5-year full recovery rate (72.7%), followed by CN V1-3 (60.3%), XII (48.6%), and II (18.2%) (p
Databáze: OpenAIRE
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