Purpose: to study the clinical, radiological, therapeutic and progressive aspects of brain radionecrosis after treatment for nasopharyngel carcinoma. Patients and methods: four patients ( two men and two women) of mean age 53.5 years were treated for UCNT( undifferentiated carcinoma of the nasopharynx), between 2009and 2014, and developed cerebral radionecrosis. All patients were treated with radical radiotherapy. The mean dose was 70 Gy. Dose per fraction was 2 Gy, one fraction daily. All patients received chemotherapy. Result: patients presented non specific neurological signs, and one case was discovered fortuitously. The mean latent periode was 46 months, brain radionecrosis was authetificated by brain imaging. The localisation was temporal in two patients and bulbomedullar in two patients. After a mean follow-up period of 14 months, clinical outcomes were favorable in one case, stabilisation in two cases and one patient died. Conclusion: brain radionecrosis is a rare iatrogenic complication for patients irradiated for UCNT. Imaging techniques play a major role in the diagnosis. Corticotherapy is the main treatment.
A 76-year-old female had spinocellular carcinoma on the left parotid area diagnosed by biopsy and managed in 2016 by large resection of the tumor with Exofacial parotidectomy extended to the skin and cervical lymph node dissection, anatompathological findings returned in favor of marginal deep limit. An adjuvant radiotherapy was indicated, but the patient refused any additional treatment.Six months later, the patient returned with a huge ulcerated and bleeding mass in the same region (Figure 1). After a positive biopsy. 66 Gy in 33 fractions were prescribed using 3D-conformal radiation therapy. Unfortunately, the patient was lost to follow-up.
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