鼻咽癌放疗后鼻咽骨坏死的临床特征、处理及长期结局：单中心经验
Clinical characteristics, management, and long-term outcomes of nasopharyngeal osteoradionecrosis after radiotherapy for nasopharyngeal carcinoma: a single-institution experience.
文献信息
| PMID | 42966810 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Juwon Hwang |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, 322, Seoyang-ro, Jeonnam, Hwasun, 58128, Republic of Korea. Leen3L@hanmail.net. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 鼻咽骨坏死（ORN）是鼻咽癌（NPC）放疗后少见但严重的晚期并发症。本研究旨在描述单中心诊治的鼻咽ORN的临床特征、处理策略及长期结局。
方法： 我们回顾性分析了在本机构接受放疗的NPC患者，并识别出随后发生鼻咽ORN的患者。分析人口学资料、放疗相关因素、就诊症状、内镜及影像学表现、治疗方式以及肿瘤学和功能结局。特别关注内镜下清创和鼻中隔瓣（NSF）重建的作用。
结果： 在325例接受放疗的NPC患者中，13例发生鼻咽ORN，观察频率为4.0%。本研究凸显了该病的罕见性，并提供了延长的纵向数据，中位随访时间为105个月。临床表现和病变范围各异，治疗根据坏死负荷和组织状态个体化制定。内镜下清创被用作一种外科处理选择，NSF重建在部分患者中可为创面提供带血管覆盖，具有可行性。长期随访提供了关于疾病控制、治疗反应和晚期结局的有意义信息。
结论： NPC放疗后鼻咽ORN是一种罕见但具有临床意义的疾病。在有临床指征时可考虑内镜下清创，选择性NSF重建在适当选择的患者中可能是一种可行的重建选择。这一单中心经验增加了长期结局数据，可能有助于指导受累患者的诊断、治疗计划和监测。
英文摘要
BACKGROUND: Nasopharyngeal osteoradionecrosis (ORN) is an uncommon but serious late complication after radiotherapy for nasopharyngeal carcinoma (NPC). This study aimed to characterize the clinical features, management strategies, and long-term outcomes of nasopharyngeal ORN treated at a single institution.
METHODS: We retrospectively reviewed patients with NPC who underwent radiotherapy at our institution and identified those who subsequently developed nasopharyngeal ORN. Demographic data, radiation-related factors, presenting symptoms, endoscopic and radiologic findings, treatment modalities, and oncologic and functional outcomes were analyzed. Particular attention was given to the role of endoscopic debridement and nasoseptal flap (NSF) reconstruction.
RESULTS: Among 325 patients with NPC treated with radiotherapy, 13 developed nasopharyngeal ORN, corresponding to an observed frequency of 4.0%. This study highlights the rarity of this condition and provides extended longitudinal data, with a median follow-up of 105 months. Clinical presentation and disease extent varied, and treatment was individualized according to necrotic burden and tissue status. Endoscopic debridement was used as a surgical management option, and NSF reconstruction was feasible for providing vascularized wound coverage in selected patients. Long-term follow-up demonstrated meaningful information regarding disease control, treatment response, and late outcomes.
CONCLUSIONS: Nasopharyngeal ORN after radiotherapy for NPC is a rare but clinically significant entity. Endoscopic debridement may be considered when clinically indicated, and selective NSF reconstruction may represent a feasible reconstructive option in appropriately selected patients. This single-institution experience adds long-term outcome data that may help guide diagnosis, treatment planning, and surveillance in affected patients.