Nasal irrigation reduces postirradiation rhinosinusitis in patients with nasopharyngeal carcinoma.
BACKGROUND
Nasopharyngeal carcinoma (NPC) is a common head and neck cancer in Taiwan. Radiotherapy (RT) is the standard treatment for NPC. The newer RT technique, intensity-modulated radiotherapy (IMRT) has become popular in recent years. IMRT-induced rhinosinusitis is not uncommon in postirradiated NPC patients but the incidence and the disease course have not been reported. The purpose of this study was to determine the IMRT effect on the paranasal sinuses and evaluate the efficacy of nasal irrigation on the management of RT-induced rhinosinusitis.


METHODS
NPC patients who completed IMRT from October 2004 to May 2006 were enrolled in the study and were randomly allocated to irrigation or nonirrigation groups. Patients in the irrigation group performed daily nasal irrigation until 6 months after RT. The severity of postirradiated rhinosinusitis was evaluated by nasal endoscopy, questionnaire, and computed tomography until a year after RT.


RESULTS
One hundred seven postirradiated NPC patients completed the study. Among them, 44 patients performed daily nasal irrigation until 6 months after RT, and the other 63 patients did not perform nasal irrigation after RT. Patients in the irrigation group had significantly lower endoscopic and questionnaire scores than patients in the nonirrigation group (p = 0.001 and 0.0001, respectively) from pre-RT to 6 months after RT. The between-group differences were most obvious at the post-RT second and third months.


CONCLUSIONS
Rhinosinusitis is a common acute post-RT complication in NPC patients. Our results showed that nasal irrigation was a safe and effective method for the management of this acute complication.
Liang
Kai-Li
KL
Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan.
Kao
Ta-Cheng
TC
Lin
Jin-Ching
JC
Tseng
Hung-Cheng
HC
Su
Mao-Chang
MC
Hsin
Chung-Han
CH
Shiao
Jiun-Yih
JY
Jiang
Rong-San
RS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology / Q000528:radiation effects; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D010256:Paranasal Sinuses / Q000473:pathology / Q000528:radiation effects; D011832:Radiation Injuries / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012189:Retrospective Studies; D012220:Rhinitis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D012720:Severity of Illness Index; D012852:Sinusitis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D012965:Sodium Chloride / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D012965:Sodium Chloride