Postradiotherapy nasopharyngeal necrosis with granulation mass: Insights from a multicentre study

Oral Oncol. 2025 Jan 8:161:107170. doi: 10.1016/j.oraloncology.2024.107170. Online ahead of print.

Abstract

Background: Postradiotherapy nasopharyngeal necrosis with granulation mass (PRNN-GM) is a rare subtype of postradiotherapy nasopharyngeal necrosis (PRNN). It is characterized by the formation of isolated granulomatous tissue masses or masses combined with PRNN. However, the relationship between clinical features and survival outcomes in PRNN-GM remains unclear.

Methods: This retrospective study systematically evaluated 33 pathologically diagnosed PRNN-GM patients treated at three medical centres from January 2010 to May 2024. The clinical features, endoscopic and imaging characteristics, treatment methods, and survival outcomes of the patients were analysed.

Results: Among the 33 patients, 27 were male and 6 were female, with a mean age of 52 years (±10.9 years). Internal carotid artery exposure was observed in 5 patients. Nineteen patients underwent surgical treatment, whereas 14 received conservative management. Internal carotid artery exposure (OR = 6.863, 95 % CI: 1.196-39.385) and surgical treatment (OR = 0.130, 95 % CI: 0.026-0.659) were identified as independent prognostic factors influencing survival outcomes (P < 0.05).

Conclusions: Patients with PRNN-GM who have internal carotid artery exposure and do not undergo surgical treatment tend to have a poorer prognosis.

Keywords: Diagnosis; Granulation tissue; Nasopharyngeal carcinoma; Postradiotherapy nasopharyngeal necrosis; Prognosis.