鼻咽癌放疗后副鼻窦炎的临床观察及影响因素分析

Occurrence and Influencing Factors of Paranasal Sinusitis in Nasopharyngeal Carcinoma Patients after Radiotherapy

背景与目的:鼻咽癌放疗后常常合并副鼻窦炎,严重影响患者生活质量。本文旨在了解鼻咽癌患者放射治疗前、后副鼻窦炎的发生情况,探讨放疗后副鼻窦炎的发生、发展规律及其影响因素。方法:收集中山大学肿瘤防治中心1998年1月至2000年7月住院治疗381例鼻咽癌患者的临床资料,阅读并比较其放疗前、后鼻咽部CT片,总结副鼻窦炎的发生情况并分析其影响因素。结果:放疗前176例患者合并有副鼻窦炎,发生率为46.2%;放疗前无副鼻窦炎的205例患者中,放疗后103例发生副鼻窦炎,副鼻窦炎发生率为50.2%;放疗后1个月、3个月、6个月及1年副鼻窦炎的发生率分别为21.0%、33.7%、41.5%及29.3%,具有统计学差异(χ2=20.92,P<0.001)。Logistic分析,T分期与放疗后副鼻窦炎发生有关。结论:鼻咽癌患者放疗后副鼻窦炎的发生率较高,以6个月时为最高峰;肿瘤的T分期与放疗后副鼻窦炎的发生有关。

BACKGROUND ＆ OBJECTIVE： Radiation usually results in paranasal sinusitis in nasopharyngeal carcinoma （NPC） patients, which influences patient＇s quality of life. This study was to explore the occurrence and influencing factors of paranasal sinusitis in NPC patients before and after radiotherapy. METHODS： Clinical data of 381 NPC patients, treated in Cancer Center of Sun Yat-sen University from Jan. 1998 to Jul. 2000, were reviewed. CT images before and after radiotherapy were compared. The occurrence and influencing factors of paranasal sinusitis were analyzed. RESULTS. Of the 381 NPC patients, 176 （46.2%） suffered from paranasal sinusitis before radiotherapy. Among the 205 NPC patients without paranasal sinusitis before radiotherapy, 103 （50.2%） developed paranasal sinusitis after radiotherapy; the occurrence rates of paranasal sinusitis at 1 month, 3 months, 6 months, and 1 year after radiotherapy were 21.0%, 33.7%, 41.5% and 29.3%, respectively （X^2=20.92, P〈0.001）. Logistic analysis showed that T stage was related to the occurrence rate of paranasal sinusitis. CONCLUSION. The incidence of paranasal sinusitis in NPC patients after radiotherapy is high and related to T stage.