Lu Yen-Ting, Lu Ying-Chou, Cheng Hui-Chen, Hsin Chung-Han, Yang Shun-Fa, Wang Po-Hui, Yeh Huan-Jui
Department of Otolaryngology, St. Martin De Porres Hospital, Chiayi, Taiwan.
Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan.
Int Forum Allergy Rhinol. 2020 May;10(5):692-697. doi: 10.1002/alr.22526. Epub 2020 Feb 13.
Chronic rhinosinusitis (CRS) is a common post-radiotherapy (RT) side effect in patients with nasopharyngeal cancer (NPC). However, whether RT is a risk factor for CRS in patients with other types of head and neck cancer remains unclear. This study investigated the association, if any, between CRS and RT in patients with head and neck cancer.
This retrospective cohort study included the data of patients newly diagnosed as having head and neck cancer between January 1, 2005, and December 31, 2008, from the 2005 Longitudinal Health Insurance Database. Patients were categorized into the following groups according to the treatment regimens received: RT alone (RT-alone), RT combined with other treatments (any-RT), and treatments without RT (no-RT). The outcome was the occurrence of CRS after treatment.
Of the 701 patients, 7% experienced CRS within 5 years after initial treatment. Patients were divided into subgroups according to different treatment policies, and the RT-alone group, any-RT group, and no-RT group had 5-year incidence of CRS of 12%, 9.3%, and 4.5%, respectively. Patients in the RT-alone and any-RT groups exhibited an increased risk of CRS compared with patients in the no-RT group (hazard ratio: 6.76 and 2.91; 95% confidence interval: 2.60 to 17.5 and 1.60 to 5.31, respectively).
This is the first nationwide population-based cohort study to evaluate the risk of posttreatment CRS in patients with head and neck cancer. Our findings indicate that RT is a major risk factor for CRS. Thus, physicians should consider this potential risk in patients with head and neck cancer after RT.
慢性鼻-鼻窦炎（CRS）是鼻咽癌（NPC）患者放疗（RT）后常见的副作用。然而，RT是否为其他类型头颈癌患者发生CRS的危险因素仍不明确。本研究调查了头颈癌患者中CRS与RT之间的关联（若存在关联）。
这项回顾性队列研究纳入了2005年纵向健康保险数据库中2005年1月1日至2008年12月31日新诊断为头颈癌患者的数据。根据接受的治疗方案，将患者分为以下几组：单纯放疗（RT-alone）、放疗联合其他治疗（any-RT）以及未接受放疗的治疗（no-RT）。观察指标为治疗后CRS的发生情况。
701例患者中，7%在初始治疗后5年内发生CRS。根据不同治疗策略将患者分为亚组，RT-alone组、any-RT组和no-RT组的CRS 5年发生率分别为12%、9.3%和4.5%。与no-RT组患者相比，RT-alone组和any-RT组患者发生CRS的风险增加（风险比：分别为6.76和2.91；95%置信区间：分别为2.60至17.5和1.60至5.31）。
这是第一项基于全国人群的队列研究，旨在评估头颈癌患者治疗后CRS的风险。我们的研究结果表明，放疗是CRS的主要危险因素。因此，医生应在头颈癌患者放疗后考虑这一潜在风险。
