鼻咽癌放疗后鼻并发症Logistic回归分析

Analysis of the nasal complication after radiotherapy in patients with nasopharyngeal carcinoma by Logistic regression

目的 :探讨鼻咽癌患者放疗后发生远期鼻并发症的相关因素。方法 :随访观察 131例鼻咽癌患者放疗后的鼻疾病 ,将可能影响并发症发生的有关因素通过Logistic回归模型分析。 结果 :放疗后最常出现的并发症是慢性化脓性鼻窦炎 (116 / 131) ,选入回归方程的因素有T分期、鼻前野照射 ;其次是鼻粘连 (33/ 131) ,选入的因素有鼻咽腔外照射总剂量、鼻咽腔内照射、药物性鼻炎 ;萎缩性鼻炎少见 (9/ 131) ,选入的因素有同时期化疗、药物性鼻炎。结论 :肿瘤的T分期、鼻前野照射与放疗后鼻窦炎的发生有关 ;鼻咽腔外照射剂量越高 ,或加做鼻咽腔内照射以及长期过量使用鼻血管收缩剂 ,容易导致鼻粘连 ;使用化疗药物及鼻血管收缩剂 。

Objective:To study of the risk factors of the nasal complication after radiotherapy in patients with nasopharyngeal carcinoma(NPC). Method:Observed 131 cases nasal disease in NPC patients, analyzed the factors that might cause the complication by using Logistic regression model. Result:The highest incidences of complication after radiotherapy was chronic purulent sinusitis (116/131), the chosen factors in the regression formula were T staging and radiation for anterior field of the nose. The second was nasal synechia(33/131), the chosen factors were total dose of external irradiation, intracavitary irradiation and medicamentous rhinitis. The incidences of atrophic rhinitis was the lowest (9/131), the chosen factors were chemotherapy and medicamentous rhinitis. Conclusion:T staging of tumor and radiation for anterior field of the nose had relation with post radiotherapy sinusitis. It was easy to lead to nasal synechia when the does of external irradiation being higher or adding intracavitary irradiation or using the decongestant for long time. Chemotherapeutic drugs and decongestant may be the risk factors of atrophic rhinitis.