鼻咽癌放射治疗后鼻窦炎相关因素分析

Analysis of related factors of nasosinusitis after radiotherapy for nasopharyngeal carcinoma

目的 研究鼻咽癌放射治疗后鼻窦炎的发生率、临床特点及相关因素。方法 通过观察 5 13例鼻咽癌放射治疗前后的鼻咽及鼻窦临床症状和影像学改变特点 ,分析鼻咽癌放射治疗后放射性鼻窦炎的发生率和影响因素。结果 5 13例鼻咽癌患者中 ,放射治疗前 5 1例伴有鼻窦炎(9 9% ) ,4 6 2例无鼻窦炎表现 (90 1% ) ;放射治疗后鼻窦炎发生率为 86 8% (40 1/46 2 ) ,鼻咽癌患者放射治疗前后鼻窦炎发生率差异有显著性 (χ2 =5 33 2 1,P <0 0 1)。 4 0 1例患者先后在放射治疗末期、放射治疗后 3个月、6个月、12个月和 18个月出现鼻窦炎症状 ,发生率分别为 10 7% (43/40 1)、13 7%(5 5 /40 1)、5 8 1% (2 33/40 1)、12 0 % (48/40 1)、5 5 % (2 2 /40 1)。分段放射治疗与连续性全程放射治疗后鼻窦炎发生率分别为 35 7% (14 3/40 1)、6 4 3% (2 5 8/40 1)。结论 放射性鼻窦炎发生率较高 ,放射剂量对其发生率有较大影响 ,与鼻咽肿瘤浸润范围无关。

Objective To study the incidence, clinical features and related factors of nasosinusitis after radiotherapy for nasopharyngeal carcinoma. Methods Five handred and thirteen patients with nasopharyngeal carcinoma were included in the study, to observe the clinical manifestation and image changes before and after radiotherapy. The incidence and influencing factors of nasosinusitis after radiotherapy were analyzed. Results Among 513 patients, before radiotherapy, nasosinusitis was found in 51 patients (9 9%). After radiotherapy, another 401 nasosinusitis was found (401/462). The difference of incidence rate of nasosinusitis before and after radiotherapy was obvious (χ 2=533 21, P <0 01). The incidence rate of nasosinusitis in the end of radiotherapy, 3 months, 6 months, 12 months and 18 months after radiotherapy was 10 7% (43/401), 13 7% (55/401), 58 1% (233/401), 12 0% (48/401), 5 5% (22/401) respectively. The incidence rate of nasosinusitis after fractional radiotherapy and continuous radiotherapy was 35 7% (143/401), 64 3% (258/401) respectively. Conclusion The incidence rate of nasosinusitis after radiotherapy is very high. It is influenced by the dose of radiotherapy, but it has no relation with the extension of nasopharyngeal carcinoma.