Meltem DAĞDELEN, İsmail Fatih DEMİREL, Sevda YENER, Songül ÇAVDAR KARAÇAM, Günay CAN, Ömer Erol UZEL
Turkish Journal of Oncology - 2025;40(4):257-263
OBJECTIVE: This study aimed to assess the incidence and dosimetric predictors of radiation-induced lower cranial nerve (CN 9 -12) palsy in patients with nasopharyngeal carcinoma (NPC), treated with intensity-modulated radiotherapy (IMRT) +/- chemotherapy. METHODS: A total of 125 patients with histologically confirmed NPC who underwent radiotherapy (RT) with or without chemotherapy between 2010 and 2024 were retrospectively reviewed. Lower cranial nerves (CN 9-12) were contoured, and dose-volume parameters including Dmax, Dmean, D2cc, D1cc, and D0.5cc were analyzed. Statistical analyses were conducted using the Mann-Whitney U test and Cox regression to assess associations between clinical features, radiation dose, and the incidence of nerve palsy. RESULTS: Median follow-up was 44 months. Cranial nerve palsy was observed in 8 patients (6.4%), all involving CN 12, with concomitant CN 9 -11 involvement in 5 cases. No statistically significant correlation was found between palsy and patient characteristics or dosimetric parameters. CONCLUSION: Although our study did not demonstrate statistically significant associations, likely due to limited sample size, contouring and sparing of lower cranial nerves in radiotherapy planning are crucial. These nerves play a vital role in preserving long-term quality of life, and their protection should be integrated into routine clinical practice.
