Department of Radiation Oncology, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung, 807, Taiwan.
Department of Radiation Oncology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Radiat Oncol. 2019 Apr 11;14(1):61. doi: 10.1186/s13014-019-1261-9.
This study investigated the impact of post-radiation sinusitis on the prognosis of nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiation therapy (IMRT).
Two hundred and thirty patients with non-metastatic NPC were analyzed in terms of freedom from local failure (FFLF), freedom from distant failure (FFDF), overall survival (OS), and disease-free survival (DFS). For each patient, the status of the sinus mucosa was flexibly assessed by documenting mucosal changes as indicated by differences between images obtained before radiotherapy and more than 6 months post-radiation.
With a median follow-up of 39.7 months (8 to 81 months), 19 (8.26%) patients relapsed locally, 13 (5.65%) patients failed in the neck, and 26 (11.3%) patients developed distant metastases. The presence of sinusitis noted in images post-radiation was a significant predictor for DFS (p = 0.001), FFLF (p = 0.004), and FFDF (p = 0.015), in addition to having high negative predictive value for local relapse (97.5%).
This is the first study to investigate the prognostic value of post-radiation sinusitis in NPC patients treated with IMRT. Post-radiation sinusitis was found to be a significant predictor for DFS, FFLF, and FFDF, and was also found to have high negative predictive value for local recurrence (97.5%). It may thus be used as an additional tool for clinicians to determine the possibility of recurrence.
本研究探讨了放射性鼻窦炎对接受调强放疗（IMRT）治疗的鼻咽癌（NPC）患者预后的影响。
对 230 例非转移性 NPC 患者的无局部失败（FFLF）、无远处失败（FFDF）、总生存（OS）和无病生存（DFS）进行分析。对于每位患者，通过记录放疗前和放疗后 6 个月以上图像之间的黏膜变化，灵活评估鼻窦黏膜的状态。
中位随访 39.7 个月（8 至 81 个月），19 例（8.26%）患者局部复发，13 例（5.65%）患者颈部失败，26 例（11.3%）患者发生远处转移。放疗后图像中出现的鼻窦炎是 DFS（p=0.001）、FFLF（p=0.004）和 FFDF（p=0.015）的显著预测因素，此外对局部复发也具有高阴性预测值（97.5%）。
这是第一项研究调强放疗治疗 NPC 患者放疗后鼻窦炎预后价值的研究。放疗后鼻窦炎是 DFS、FFLF 和 FFDF 的显著预测因素，对局部复发也具有高阴性预测值（97.5%）。因此，它可以作为临床医生确定复发可能性的附加工具。
