What are the sequelae of radiotherapy for advanced nasopharyngeal carcinoma and what are the symptoms?

What are the sequelae of radiotherapy for advanced nasopharyngeal carcinoma? What are the symptoms?

Advanced nasopharyngeal cancer often invades the optic nerve near the visual chiasm, causing decreased vision, nasal or temporal blindness, and can cause blindness in one or both eyes. Fundus examination reveals optic nerve atrophy. The nerve has a long course and is located in an area that is easily invaded by nasopharyngeal cancer. It is often invaded early, causing diplopia. The eyes cannot move and are esotropia.

The sequelae of radiotherapy for advanced nasopharyngeal carcinoma are:

1. Systemic reactions: including fatigue, dizziness, loss of appetite, nausea, vomiting, no taste or smell changes in the mouth, insomnia or drowsiness, etc. Some patients may experience blood changes, especially leukopenia. Although the degree varies, it can usually be overcome and completed with symptomatic treatment.

If necessary, take vitamin B1, B6, C, metoclopramide, etc. If the white blood cell count drops to less than 3×109, the child should suspend radiotherapy.

2. Local reactions: including skin, mucous membranes and salivary glands. Skin reactions are dry dermatitis or even wet dermatitis, and 0.1% ice talcum powder or lanolin can be used topically as a base anti-inflammatory ointment. Mucosal reactions are manifested as congestion, edema, exudation and accumulation of secretions in the nasopharyngeal and oropharyngeal mucosa, and mouthwash and lubricating anti-inflammatory agents can be used topically.

In a few patients, the swelling of the parotid glands may gradually subside after 2Gy of parotid gland irradiation. When irradiated with 40Gy, saliva secretion is significantly reduced, oral mucosal secretion is increased, and the mucosa is congested and swollen. The patient has dry mouth and difficulty eating. Excessive irradiation of the parotid gland should be avoided.

3. Radiotherapy sequelae: mainly include temporomandibular joint dysfunction, soft tissue atrophy and fibrosis, radiation-induced caries, radiation-induced mandibular osteomyelitis and radiation-induced encephalomyelopathy.