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Complications of Neck Radiation Therapy
Patricia A. Hudgins, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Uncommon, unintended side effects from radiation therapy (XRT) seen in small proportion of patients

              IMAGING

              • General Features

                • Imaging Recommendations

                  • CT Findings

                    • MR Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    • Reporting Tips

                                      Selected References

                                      1. Ahmad S et al: Incidence of intracranial radiation necrosis following postoperative radiation therapy for sinonasal malignancies. Laryngoscope. ePub, 2016
                                      2. Tian YM et al: Long-term survival and late complications in intensity-modulated radiotherapy of locally recurrent T1 to T2 nasopharyngeal carcinoma. Head Neck. 38(2):225-31, 2016
                                      3. Nadella KR et al: Osteoradionecrosis of the Jaws: Clinico-Therapeutic Management: A Literature Review and Update. J Maxillofac Oral Surg. 14(4):891-901, 2015
                                      4. Phillips DJ et al: Radiation-Induced Necrosis of the Temporal Bone: Diagnosis and Management. Otol Neurotol. 36(8):1374-7, 2015
                                      5. Varoquaux A et al: Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors. Radiographics. 35(5):1502-27, 2015
                                      6. Rotteveel LJ et al: Incus necrosis after irradiation. Otol Neurotol. 34(9):1699-702, 2013
                                      7. Saito N et al: Posttreatment CT and MR imaging in head and neck cancer: what the radiologist needs to know. Radiographics. 32(5):1261-82; discussion 1282-4, 2012
                                      8. Shah R et al: Radiation necrosis in the brain: imaging features and differentiation from tumor recurrence. Radiographics. 32(5):1343-59, 2012
                                      9. Horky LL et al: Dual phase FDG-PET imaging of brain metastases provides superior assessment of recurrence versus post-treatment necrosis. J Neurooncol. 103(1):137-46, 2011
                                      10. Glastonbury CM et al: The postradiation neck: evaluating response to treatment and recognizing complications. AJR Am J Roentgenol. 195(2):W164-71, 2010
                                      11. Madrid C et al: Osteoradionecrosis: an update. Oral Oncol. 46(6):471-4, 2010
                                      12. Dirix P et al: Dysphagia after chemoradiotherapy for head-and-neck squamous cell carcinoma: dose-effect relationships for the swallowing structures. Int J Radiat Oncol Biol Phys. 75(2):385-92, 2009
                                      13. Lang K et al: Incidence and costs of treatment-related complications among patients with advanced squamous cell carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg. 135(6):582-8, 2009
                                      14. Murphy BA et al: Mucositis-related morbidity and resource utilization in head and neck cancer patients receiving radiation therapy with or without chemotherapy. J Pain Symptom Manage. 38(4):522-32, 2009
                                      15. Paraskevas KI et al: Irradiation-induced carotid artery stenosis: a preventable complication of neck radiotherapy? Angiology. 60(3):273-5, 2009
                                      16. Toda K et al: Radiation-induced cancer after radiotherapy for non-Hodgkin's lymphoma of the head and neck: a retrospective study. Radiat Oncol. 4:21, 2009
                                      17. Truong MT et al: Emerging applications of stereotactic radiotherapy in head and neck cancer. Neurosurg Focus. 27(6):E11, 2009
                                      18. Yoo JS et al: Osteoradionecrosis of the Hyoid Bone: Imaging Findings. AJNR Am J Neuroradiol. Epub ahead of print, 2009
                                      19. Corvò R: Evidence-based radiation oncology in head and neck squamous cell carcinoma. Radiother Oncol. 85(1):156-70, 2007
                                      20. Amemiya K et al: The risk of radiation-induced cancer in patients with squamous cell carcinoma of the head and neck and its results of treatment. Br J Radiol. 78(935):1028-33, 2005
                                      21. Zackrisson B et al: A systematic overview of radiation therapy effects in head and neck cancer. Acta Oncol. 42(5-6):443-61, 2003
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Uncommon, unintended side effects from radiation therapy (XRT) seen in small proportion of patients

                                                  IMAGING

                                                  • General Features

                                                    • Imaging Recommendations

                                                      • CT Findings

                                                        • MR Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Consider

                                                                      • Image Interpretation Pearls

                                                                        • Reporting Tips

                                                                          Selected References

                                                                          1. Ahmad S et al: Incidence of intracranial radiation necrosis following postoperative radiation therapy for sinonasal malignancies. Laryngoscope. ePub, 2016
                                                                          2. Tian YM et al: Long-term survival and late complications in intensity-modulated radiotherapy of locally recurrent T1 to T2 nasopharyngeal carcinoma. Head Neck. 38(2):225-31, 2016
                                                                          3. Nadella KR et al: Osteoradionecrosis of the Jaws: Clinico-Therapeutic Management: A Literature Review and Update. J Maxillofac Oral Surg. 14(4):891-901, 2015
                                                                          4. Phillips DJ et al: Radiation-Induced Necrosis of the Temporal Bone: Diagnosis and Management. Otol Neurotol. 36(8):1374-7, 2015
                                                                          5. Varoquaux A et al: Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors. Radiographics. 35(5):1502-27, 2015
                                                                          6. Rotteveel LJ et al: Incus necrosis after irradiation. Otol Neurotol. 34(9):1699-702, 2013
                                                                          7. Saito N et al: Posttreatment CT and MR imaging in head and neck cancer: what the radiologist needs to know. Radiographics. 32(5):1261-82; discussion 1282-4, 2012
                                                                          8. Shah R et al: Radiation necrosis in the brain: imaging features and differentiation from tumor recurrence. Radiographics. 32(5):1343-59, 2012
                                                                          9. Horky LL et al: Dual phase FDG-PET imaging of brain metastases provides superior assessment of recurrence versus post-treatment necrosis. J Neurooncol. 103(1):137-46, 2011
                                                                          10. Glastonbury CM et al: The postradiation neck: evaluating response to treatment and recognizing complications. AJR Am J Roentgenol. 195(2):W164-71, 2010
                                                                          11. Madrid C et al: Osteoradionecrosis: an update. Oral Oncol. 46(6):471-4, 2010
                                                                          12. Dirix P et al: Dysphagia after chemoradiotherapy for head-and-neck squamous cell carcinoma: dose-effect relationships for the swallowing structures. Int J Radiat Oncol Biol Phys. 75(2):385-92, 2009
                                                                          13. Lang K et al: Incidence and costs of treatment-related complications among patients with advanced squamous cell carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg. 135(6):582-8, 2009
                                                                          14. Murphy BA et al: Mucositis-related morbidity and resource utilization in head and neck cancer patients receiving radiation therapy with or without chemotherapy. J Pain Symptom Manage. 38(4):522-32, 2009
                                                                          15. Paraskevas KI et al: Irradiation-induced carotid artery stenosis: a preventable complication of neck radiotherapy? Angiology. 60(3):273-5, 2009
                                                                          16. Toda K et al: Radiation-induced cancer after radiotherapy for non-Hodgkin's lymphoma of the head and neck: a retrospective study. Radiat Oncol. 4:21, 2009
                                                                          17. Truong MT et al: Emerging applications of stereotactic radiotherapy in head and neck cancer. Neurosurg Focus. 27(6):E11, 2009
                                                                          18. Yoo JS et al: Osteoradionecrosis of the Hyoid Bone: Imaging Findings. AJNR Am J Neuroradiol. Epub ahead of print, 2009
                                                                          19. Corvò R: Evidence-based radiation oncology in head and neck squamous cell carcinoma. Radiother Oncol. 85(1):156-70, 2007
                                                                          20. Amemiya K et al: The risk of radiation-induced cancer in patients with squamous cell carcinoma of the head and neck and its results of treatment. Br J Radiol. 78(935):1028-33, 2005
                                                                          21. Zackrisson B et al: A systematic overview of radiation therapy effects in head and neck cancer. Acta Oncol. 42(5-6):443-61, 2003