鼻咽癌患者调强放射治疗后鼻窦炎的临床特征分析

目的 探讨鼻咽癌(NPC)患者调强适形放射治疗(简称调强放疗)后鼻窦炎的临床特点及发展规律，为更好地进行早期临床干预提供依据。方法 对已行鼻咽部病理活检确诊为NPC拟行放疗的患者进行研究。比较不同时间节点(放疗前、放疗结束时、结束后3个月、结束后6个月、结束后12个月)鼻窦炎各项评分(鼻窦炎症状评分，鼻内镜评分，CT/MRI评分)，分析各项评分与T分期、鼻腔鼻窦解剖异常的相关性。结果 NPC放疗后鼻窦炎症状评分、鼻内镜评分、CT/MRI评分在不同时间节点之间的差异均有统计学意义(χ2值分别为19.28、22.33、67.73,P值均<0.01)，各项评分在放疗结束后6个月达到峰值。不同时间节点的鼻窦炎症状评分、CT/MRI评分(除放疗结束后6个月外)均与T分期呈正相关性(P<0.05)。在不同时间节点，各项评分与鼻腔鼻窦解剖异常均无明确相关性。结论 NPC患者调强放疗后鼻窦炎有其自身的临床特点及发展规律，放疗后6个月炎症程度达峰值,不同时间节点各项评分多数与T分期相关，而与鼻腔鼻窦解剖异常无明显相关性。

Clinical features of sinusitis after intensity modulated radiotherapy in patients with nasopharyngeal carcinoma

Objective To investigate the clinical characteristics and development of sinusitis in patients with nasopharyngeal carcinoma after intensity modulated radiotherapy, and to provide a basis for early clinical intervention. Methods The patients with nasopharyngeal carcinoma confirmed by nasopharyngeal biopsy who planned to receive radiotherapy were studied. Scores of sinusitis (sinusitis symptom score, nasal endoscopic score, CT/MRI score) were compared at different time points (before radiotherapy, just after radiotherapy, 3 months after radiotherapy, 6 months after radiotherapy, and 12 months after radiotherapy), and the correlations between sinusitis scores with the T stage and nasal sinuses anatomic abnormalities were analyzed. Results Sinusitis symptoms score, nasal endoscopic score, CT/MRI score of nasopharyngeal carcinoma after radiotherapy were all statistically significant at different time points (χ² values were 19.28, 22.33, 67.73, respectively), all with significant statistical significance (P<0.01). All scores were peaked at 6 months after the end of radiotherapy. Sinusitis symptom score and CT/MRI score at different time points (except 6 months after radiotherapy) were mostly positively correlated with T stage, with statistical significance (P<0.05). There were no clear correlations between sinusitis scores at different time points and the anatomical abnormalities of the nasal cavity and sinuses. Conclusions Nasosinusitis after intense-modulated radiotherapy in nasopharyngeal carcinoma patients has its own clinical characteristics and development pattern. All scores reached to the peak at 6 months after radiotherapy. Most of sinusitis scores at different time points were correlated with T stage, but had no significant correlation with anatomical abnormalities of nasal cavity and sinuses.