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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Comparison between high-dose and low-dose intravenous methylprednisolone therapy in patients with brain necrosis after radiotherapy for nasopharyngeal carcinoma
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Comparison between high-dose and low-dose intravenous methylprednisolone therapy in patients with brain necrosis after radiotherapy for nasopharyngeal carcinoma

机译：高剂量和低剂量静脉内甲基己酮酮治疗在鼻咽癌放射治疗后脑坏死患者的比较

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Background: Radiotherapy is the standard radical treatment for nasopharyngeal carcinoma (NPC) and may cause radiation-induced brain necrosis (RN). Intravenous steroids have been considered as an effective treatment for RN. However, evidence concerning the efficacy of different doses of intravenous steroid therapy remains insufficient to establish the optimal regimen for NPC patients with RN. Methods: We retrospectively reviewed charts of 169 patients who were diagnosed with RN after radiotherapy for NPC, treated with low-dose or high-dose intravenous methylprednisolone (IVMP) and followed up for 12 months. We collected the clinical data, including the Late Effects of Normal Tissue (LENT)/Subjective, Objective, Management, Analytic (SOMA) scales score and Montreal Cognitive Assessment (MoCA) score. Magnetic resonance imaging (MR1) was performed pre- and post-treatment to define the radiographic response. Results: There were no significant differences in the treatment response based on MRI, or changes in clinical symptoms and cognitive function between low and high-dose groups. Thirty of 93 low-dose patients (32.3%) and 21 of 76 high-dose patients (27.6%) presented effective response in MRI, with no significant differences between groups (P = 0.515). Neither group showed a significant difference in the effective rate based on the MoCA total score and LENT/SOMA score. The most commonly reported grade 3 adverse events in the high-dose group (n = 76) were infections and infestations (3 [3.9%] vs. none for low-dose group). Conclusions: We found low-dose IVMP was not inferior to high-dose IVMP for NPC patients with RN. In addition, treatment-related infections and infestations were likewise more common with high-dose steroid than low-dose steroid.
机译：背景：放射疗法是鼻咽癌（NPC）的标准自由基治疗，可能导致辐射诱导的脑坏死（RN）。静脉内固醇被认为是RN的有效治疗方法。然而，有关不同剂量的静脉内类固醇治疗的疗效的证据仍然不足以建立NPC患者的最佳方案。方法：回顾性地审查了169名患者的图表，在NPC放疗后被诊断为RN，用低剂量或高剂量静脉内甲基丙酮（IVMP）处理并随访12个月。我们收集了临床资料，包括正常组织（借出）/主观，目标，管理，分析（SOMA）秤分数和蒙特利尔认知评估（MOCA）得分的临床数据。进行磁共振成像（MR1）进行预处理以定义射线照相反应。结果：基于MRI的治疗响应没有显着差异，或低剂量组之间的临床症状和认知功能的变化。 393名低剂量患者（32.3％）和21例，76名高剂量患者（27.6％）在MRI中呈现有效反应，之间没有显着差异（P = 0.515）。既不是基于MOCA总分和借出的遗传率和借出的遗传/素质评分均未出现显着差异。在高剂量组（n = 76）中最常见的3级不良事件是感染和侵扰（3 [3.9％]对低剂量组的影响）。结论：我们发现低剂量IVMP对NPC患者的高剂量IVMP不逊色于RN。此外，与低剂量类固醇的高剂量类固醇同样比低剂量类固醇更常见的治疗相关的感染和侵扰。

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