{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T13:10:19Z","timestamp":1782738619021,"version":"3.54.5"},"reference-count":79,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Cerebral radiation necrosis (CRN) is one of the most prominent sequelae following radiation therapy for nasopharyngeal carcinoma (NPC), which might have devastating effects on patients\u2019 quality of life (QOL). Advances in histopathology and neuro-radiology have shed light on the management of CRN more comprehensively, yet effective therapeutic interventions are still lacking. CRN was once regarded as progressive and irreversible, however, in the past 20 years, with the application of intensity-modulated radiation therapy (IMRT), both the incidence and severity of CRN have declined. In addition, newly developed medical agents including bevacizumab-a humanized monoclonal antibody against vascular endothelial growth factor (VEGF), nerve growth factor (NGF), monosialotetrahexosylganglioside (GM1), etc., have shown great potency in successfully reversing radiation-induced CRN. As temporal lobes are most frequently compromised in NPC patients, this review will summarize the state-of-the-art progress regarding the incidence, pathophysiology, prevention, treatment, and prognosis of temporal lobe necrosis (TLN) after IMRT in NPC.<\/jats:p>","DOI":"10.3389\/fonc.2020.593487","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T09:24:46Z","timestamp":1611221086000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Temporal Lobe Necrosis Following Radiotherapy in Nasopharyngeal Carcinoma: New Insight Into the Management"],"prefix":"10.3389","volume":"10","author":[{"given":"Xin","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiyao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoshen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,1,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1186\/1471-2407-13-397","article-title":"Radiation-induced temporal lobe injury after intensity modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume-outcome analysis","volume":"13","author":"Sun","year":"2013","journal-title":"BMC Cancer"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e36529","DOI":"10.1371\/journal.pone.0036529","article-title":"Psychological disorders, cognitive dysfunction and quality of life in nasopharyngeal carcinoma patients with radiation-induced brain injury","volume":"7","author":"Tang","year":"2012","journal-title":"PloS One"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djy150","article-title":"Genome-Wide Association Study of Susceptibility Loci for Radiation-Induced Brain Injury","volume":"111","author":"Wang","year":"2019","journal-title":"J Natl Cancer Inst"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e67488","DOI":"10.1371\/journal.pone.0067488","article-title":"Radiation-induced temporal lobe injury for nasopharyngeal carcinoma: a comparison of intensity-modulated radiotherapy and conventional two-dimensional radiotherapy","volume":"8","author":"Zhou","year":"2013","journal-title":"PloS One"},{"key":"B5","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1038\/bjc.2013.720","article-title":"Late toxicities after intensity-modulated radiotherapy for nasopharyngeal carcinoma: patient and treatment-related risk factors","volume":"110","author":"Zeng","year":"2014","journal-title":"Br J Cancer"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-013-1419-z","article-title":"Experience with combination of cetuximab plus intensity-modulated radiotherapy with or without chemotherapy for locoregionally advanced nasopharyngeal carcinoma","volume":"139","author":"Niu","year":"2013","journal-title":"J Cancer Res Clin Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2017.11.038","article-title":"Prospective, Multicenter, Phase 2 Trial of Induction Chemotherapy Followed by Bio-Chemoradiotherapy for Locally Advanced Recurrent Nasopharyngeal Carcinoma","volume":"100","author":"Ng","year":"2018","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(00)00786-0","article-title":"Final report of a randomized trial on altered-fractionated radiotherapy in nasopharyngeal carcinoma prematurely terminated by significant increase in neurologic complications","volume":"48","author":"Teo","year":"2000","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B9","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/S0360-3016(97)00580-4","article-title":"Effect of time, dose, and fractionation on temporal lobe necrosis following radiotherapy for nasopharyngeal carcinoma","volume":"40","author":"Lee","year":"1998","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2012.08.013","article-title":"A prospective, randomized study comparing outcomes and toxicities of intensity-modulated radiotherapy vs. conventional two-dimensional radiotherapy for the treatment of nasopharyngeal carcinoma","volume":"104","author":"Peng","year":"2012","journal-title":"Radiother Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1159\/000411642","article-title":"The risk of cerebral radionecrosis in relation to dose, time and fractionation. 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