Characterization of cerebral radiation necrosis following the treatment of sinonasal malignancies

Abstract

Abstract Objectives Our study aims to determine the incidence and potential risk factors for cerebral radiation necrosis (CRN) following treatment of sinonasal malignancies. Methods One hundred thirty‐two patients diagnosed with sinonasal malignancies over an 18‐year period were identified at two institutions. Forty‐six patients meeting inclusion criteria and treated with radiation therapy were included for analysis. Demographic and clinical‐pathologic characteristics were collected and reviewed. Post‐treatment magnetic resonance imaging (MRI) at least 1 year following treatment was reviewed to determine presence or absence of CRN. Results CRN was identified on MRI in 8 of 46 patients (17.4%) following radiation treatment. Patients with a history of reirradiation were more likely to develop CRN (50% vs. 10.5%, p .05). CRN patients had a higher proportion of tumors with skull base involvement than non‐CRN patients (100% vs. 57.9%, p = .037). Demographics, comorbidities, pathology, primary tumor subsite, chemotherapy use, and stage of disease demonstrated no significant increase in risk of CRN. Conclusions Reirradiation and tumor skull base involvement were significant risk factors associated with CRN. Higher average total prescribed and BEDs of radiation were seen in the CRN groups, but these differences were not statistically significant. Gender, comorbidities, tumor subsite, tumor location, and treatment type were not significantly different between groups. Level of evidence Level 3.

Keywords

• cerebral radiation necrosis
• nose and paranasal sinuses
• radiation therapy
• Sinonasal malignancies
• sinus cancer