鼻咽癌放疗后致迟发性放射性脑病34例临床分析

目的：探讨鼻咽癌放疗后致迟发性放射性脑病的临床特征。方法：对中南大学湘雅医院神经内科所收治的34例鼻咽癌放疗后致迟发性放射性脑病患者临床资料、治疗方法及预后进行回顾性研究。结果：34例迟发性放射性脑病患者的临床特征包括头痛、头晕、记忆力下降、精神异常、抽搐、复视、面瘫或面部麻木、听力下降、言语增多、肢体无力、走路不稳、肢端麻木等。头部MRIT1WI呈低信号,T2WI呈高信号,增强后呈不规则强化。34例均随访,其中死亡11例,占32.35%;现存活23例,17例伴有严重症状,生存质量差,占50%。结论：鼻咽癌放疗后致迟发性放射性脑病临床表现各异,患者预后较差,临床上需尽早诊断,积极治疗,定期随诊。

Clinical Analysis of 34 patients with Delayed Radiation Encephalopathy following Radiotherapy for Nasopharyngeal Carcinoma

Objective： To evaluate the clinical features of delayed radiation encephalopathy （RE） following radiotherapy for nasopharyngeal carcinoma （NPC）. Methods： The clinical materials of 34 patients with delayed RE were analyzed retrospectively. Results： Patients presented headache, dizziness, memory decrease, mental anomaly, spasm, diplopia, facial paralysis, hearing loss, running off at the mouth, limb fatigue, walking unsteady, and limb anesthesia. MRI showed low signal intensity on TIWI and high intensity on T2WI with irregular enhancement. All 34 cases were followed up, among which 11 cases died （32.35%）; 17 cases had poor living quality with severe symptoms （50%）. Conclusions： Delayed RE following radiotherapy for NPC has various clinical features, and poor prognosis. Therefore, the patients should be diagnosed early, treated positively, and followed up regularly.