Sinus mucosa status in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy: A 5-year follow-up

Head Neck. 2016 Jan;38(1):29-35. doi: 10.1002/hed.23849. Epub 2015 Apr 6.

Abstract

Background: Sinus mucosa abnormalities on image studies, which is the major diagnostic measure for sinusitis, were investigated in patients with nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT).

Methods: A retrospective review of the MRIs for patients with NPC was conducted. Sinus mucosa abnormalities were staged by the Lund-Mackay system.

Results: A total of 94 patients were enrolled in this study. The rate and severity of sinus abnormalities were highest on the third postradiotherapy month (p < .005, t test). There was no significant increase in the incidence of abnormalities on the fifth postradiotherapy year (t test). The anterior ethmoid and maxillary sinuses were the most affected sinuses before and after radiotherapy (p < .005, chi-square test).

Conclusion: Our data showed that the anterior ethmoid and maxillary sinuses were the most vulnerable sinuses for therapeutic toxicity after IMRT in patients with NPC. In the long run, however, the application of IMRT does not significantly increase the incidence of sinus toxicities.

Keywords: MRI; complication; intensity-modulated radiotherapy; nasopharyngeal carcinoma; rhinosinusitis.

MeSH terms

  • Adult
  • Aged
  • Carcinoma
  • Ethmoid Bone / pathology
  • Ethmoid Bone / radiation effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Male
  • Maxillary Sinus / pathology
  • Maxillary Sinus / radiation effects*
  • Middle Aged
  • Mucous Membrane / pathology
  • Nasopharyngeal Carcinoma
  • Nasopharyngeal Neoplasms / radiotherapy*
  • Predictive Value of Tests
  • Radiotherapy Dosage
  • Radiotherapy, Intensity-Modulated / adverse effects*
  • Radiotherapy, Intensity-Modulated / methods
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Sinusitis / diagnosis*
  • Sinusitis / etiology*