Deep radiation-induced ulcer following nasopharyngeal carcinoma: surgical management

Hallak, Bassel; Morrison, Miranda; Köhler, R; Bouayed, Salim

doi:10.1136/bcr-2019-230700

Cited by 9 publications

(8 citation statements)

References 7 publications

(6 reference statements)

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“…About 101 studies remained after removal of duplicate studies; 72 articles were excluded after viewing title, abstract, or full text for reasons such as not including patients with skull base ORN, no treatment offered for skull base ORN, animal studies, or cadaver studies; and 29 studies were included in the final analysis. 3 22 23 24 25 29 31 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 The literature search protocol for selection of eligible studies is presented as a PRISMA flow diagram in Supplementary Figs. S1 and S2 (available in the online version).…”

Section: Resultsmentioning

confidence: 99%

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Treatment Outcomes for Osteoradionecrosis of the Central Skull Base: A Systematic Review

Shaikh

Makary

Ryan

et al. 2021

J Neurol Surg B Skull Base

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Objective Osteoradionecrosis (ORN) of the skull base can have catastrophic consequences if not detected early and managed appropriately. This is a systematic review of the different treatment modalities for skull base ORN and their outcomes. Study Design This study is a systematic review. Materials and Methods Two researchers extracted information including patient population, surgical technique, outcomes of interest, and study design. A computerized search of Medline, Embase, and the Cochrane library (January 1990–June 2020) looked for several papers on the subject of skull base ORN. Results A total of 29 studies had met inclusion criteria, including data from 333 patients. Nasopharyngeal carcinoma was the most common primary tumor (85%). Average age at diagnosis of ORN was 55.9 years (range = 15–80 years) and 72.3% of patients were males. The average time to diagnosis of ORN after radiation therapy was 77 months with an average radiation dose of 76.2 Gy (range = 46–202 Gy). Nighty-eight patients (29.4%) also had chemotherapy as part of their treatment regimen. Although all parts of the central skull base were reported to be involved, the clivus and sphenoid bone were the most commonly reported subsites. Trial of medical treatment had a success rate of 41.1%. About 66% of patients needed surgical treatment, either primarily or after failing medical treatment. Success rate was 77.3%. Overall, the surgical treatment was superior to medical treatment (p < 0.0001). Conclusion ORN is a rare complication of the treatment of skull base tumors. Most cases require surgical treatment, including endoscopic debridement or free flap reconstruction, which has a high success rate. Level of Evidence Level 3 evidence as a systematic review of case studies, case reports, retrospective, and prospective trials with no blinding or controls.

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Section: Resultsmentioning

confidence: 99%

“…There were two prospective studies, 24 33 five retrospective studies, 22 23 25 39 42 six case series, 40 41 46 49 51 55 and 16 case reports. 3 29 31 34 35 37 38 43 44 45 47 48 50 52 53 54 The population size in the studies varied from one to 162 patients. All studies were single-center studies.…”

Section: Resultsmentioning

confidence: 99%

Treatment Outcomes for Osteoradionecrosis of the Central Skull Base: A Systematic Review

Shaikh

Makary

Ryan

et al. 2021

J Neurol Surg B Skull Base

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“…Traditional repeated endoscopic debridement is generally applied for patients with carotid artery exposure and rupture, but only 13.4-28.6% of patients can be cured 18 . Even novel surgical management achieved limited clinical e cacy 9,18,19 . However, our study revealed that INN was not an independent prognostic factor for OS and PFS, which indicated that INN had limited in uence on patients' survival after the primary IMRT.…”

Section: Clinical Feature and Prognosis Of Innmentioning

confidence: 99%

Irradiation-Induced Nasopharyngeal Necrosis in Newly Diagnosed Nasopharyngeal Carcinoma Treated by Intensity-Modulated Radiation Therapy: Clinical Characteristics and the Influence of Treatment Strategies

Xu¹,

Liu²,

Wang³

et al. 2021

Preprint

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Purpose: To define the clinical characteristics of irradiation-induced nasopharyngeal necrosis (INN) after intensity-modulated radiotherapy (IMRT) and identify the influence of treatment strategies on INN in primary nasopharyngeal carcinoma (NPC) patients.Patients and methods: From 2008 to 2019, NPC patients pathologically diagnosed with INN after primary IMRT were reviewed. Those patients were matched with propensity scores for patients without INN in our center. The impact of treatment strategies on INN occurrence was assessed using univariate and multivariate logistic regression analysis. Results: The incidence rate of INN was 1.9% among the primary NPC population, and 53 patients with INN were enrolled. Headache and foul odor were the main symptoms, and 71.7% of cases had pseudomembrane during or at the end of radiotherapy. All patients were in early or middle stage INN, and no one presented with skull-based osteoradionecrosis. Then 212 non-INN patients were included based on propensity scores match. Overall survival (p=0.248) and progression-free survival (p=0.266) curves were similar between the INN and non-INN groups. Treatment strategies including combining chemotherapy or molecular targeted therapy with radiotherapy were not associated with INN occurrence, while boost dose (OR 7.360; 95% CI 2.301-23.547; P = 0.001) was a predictor factor for it. However, the optimal threshold for an accumulated dose to predict INN's occurrence was failed to determine.Conclusion: In the IMRT era, the severity of INN in primary NPC patients is lessened. This study showed that treatment strategies contributed little to develop INN, while the accumulated dose of radiation may relate to its occurrence.

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“…Radiotherapy is currently regarded as a preferred method for treating NPC. However, at present, neither immunotherapy nor chemotherapy can completely eradicate these tumors due to the high recurrence rate and distant metastasis of NPC (Hallak et al, 2019; Hong et al, 2018; Liu et al, 2020). Patients with NPC, especially those in advanced stages, still suffer from poor overall survival (Fu et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

c‐Myc‐induced circ‐NOTCH1 promotes aggressive phenotypes of nasopharyngeal carcinoma cells by regulating the miR‐34c‐5p/c‐Myc axis

Huang

Wei

Jiang

et al. 2021

Cell Biology International

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Nasopharyngeal carcinoma (NPC) is the subclass of head and neck cancer with the highest incidence among otolaryngology malignancies. A growing amount of evidence has proven that circular RNAs (circRNAs) play key roles in the progression of multiple cancers. It has been reported that circ‐NOTCH1 is a novel circRNA and functions as an oncogene in gastric cancer, while the regulatory mechanism of circ‐NOTCH1 in NPC remains unknown. In the present research, our findings revealed that circ‐NOTCH1 was overexpressed in NPC tissues and cells. Circ‐NOTCH1 knockdown suppressed NPC cell proliferation, invasion, and migration. Subsequently, we discovered that c‐Myc can activate circ‐NOTCH1 by binding to the NOTCH1 promoter. c‐Myc functioned as a tumor promoter in NPC cells. Mechanistically, circ‐NOTCH1 served as a competitive endogenous RNA to modulate c‐Myc expression by sponging miR‐34c‐5p. Additionally, overexpression of c‐Myc reversed the circ‐NOTCH1 knockdown‐mediated inhibition of NPC cellular progression. Overall, this study suggested that c‐Myc‐induced circ‐NOTCH1 promoted malignant phenotypes of NPC cells by regulating the miR‐34c‐5p/c‐Myc axis.

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Deep radiation-induced ulcer following nasopharyngeal carcinoma: surgical management

Cited by 9 publications

References 7 publications

Treatment Outcomes for Osteoradionecrosis of the Central Skull Base: A Systematic Review

Treatment Outcomes for Osteoradionecrosis of the Central Skull Base: A Systematic Review

Irradiation-Induced Nasopharyngeal Necrosis in Newly Diagnosed Nasopharyngeal Carcinoma Treated by Intensity-Modulated Radiation Therapy: Clinical Characteristics and the Influence of Treatment Strategies

c‐Myc‐induced circ‐NOTCH1 promotes aggressive phenotypes of nasopharyngeal carcinoma cells by regulating the miR‐34c‐5p/c‐Myc axis

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