Related factors of sinusitis after radiotherapy for nasopharyngeal carcinoma / 中华放射医学与防护杂志

ABSTRACT

Objective To explore the incidence and factors of paranasal sinusitis among nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods Retrospectively evaluated the clinical data of 144 NPC patients without paranasal sinusitis before radiotherapy, including 82 cases in T1/T2 stage and 62 cases in T3/T4 stage treated in the First Affiliated Hospital of Bengbu Medical College from 2000 to 2005. MRI images before and after radiotherapy were compared. The incidence and factors of paranasal sinusitis were analyzed. There were 58 cases of nasal invasion. Nasopharyngeal carcinoma was given at face-neck joint portal with 6 MV X-ray fractionated irradiation 68-78 Gy during 6-8 weeks. The number of patients who received radiotherapy with less than or equal to 70 Gy, more than 70 Gy radiation doses were 89 and 55, respectively. Cervical part were treated with high-energy electron beam, patients with positive neck lymph nodes and with negative neck lymph nodes received 64-74 Gy doses during 6-8 weeks and 50-54 Gy during 4-5 weeks, respectively. Results Among the 144 NPC patients 86.8%(125/144) developed paranasal sinusitis after radiotherapy, the incidence rates of paranasal sinusitis (IRPS) was higher among stage T3 + T4 patients than that among stage T1 + T2 patients (94% vs 82% ,x2=4.32, P ＜0.05). Among patients who were given radiotherapy with more than 70 Gy,less than or equal to 70 Gy radiation doses on the nasopharynx, the IRPS were 95% and 82.0% (x2 = 4.65, P ＜ 0.05 ). The IRPS in patients with nasal cavity infringement was higher than that in others (95% vs. 81% , x2 = 5.46,P ＜0.05). The IRPS at 3, 6, 12 months, and more than 1 year after radiotherapy were 13.6% ,31.2% ,48.8% and 6.4%, respectively (x2 = 70.48, P ＜ 0.001 ). Conclusions The incidence of paranasal sinusitis in NPC patients after radiotherapy was very high, and reached a peak in one year. It was influeneed by invasion of nasal cavity or not, the dose of radiotherapy and T stage.