title: Factors influencing the incidence of sinusitis in nasopharyngeal carcinoma patients after intensity-modulated radiation therapy.
abstract: The aim of the study was to investigate the incidence of sinusitis in nasopharyngeal carcinoma (NPC) patients before and after intensity-modulated radiation therapy (IMRT) and to analyze factors associated with the incidence of sinusitis following IMRT. We retrospectively analyzed 283 NPC patients who received IMRT in our hospital from March 2009 to May 2011. The diagnostic criteria for sinusitis are based on computed tomography (CT) or magnetic resonance imaging (MRI) findings. CT or MRI scans were performed before and after IMRT to evaluate the incidence of sinusitis. Factors influencing the incidence of sinusitis were analyzed by log-rank univariate and logistic multivariate analyses. Among the 283 NPC patients, 128 (45.2 %) suffered from sinusitis before radiotherapy. The incidence rates of sinusitis in patients with T1, T2, T3, and T4 NPC before radiotherapy were 22.6, 37.5, 46.8, and 61.3 %, respectively (χ 2 = 14.548, p = 0.002). Among the 155 NPC patients without sinusitis before radiotherapy, the incidence rates of sinusitis at the end of radiotherapy and at 1, 3, 6, 9, 12, and 18 months after radiotherapy were 32.9, 43.2, 61.3, 68.4, 73.5, 69.7, and 61.3 %, respectively (χ 2 = 86.461, p < 0.001). Univariate analysis showed that T stage, invasion of the nasal cavity, nasal irrigation, and radiation dose to the nasopharynx were associated with the incidence of sinusitis in NPC patients after IMRT (p = 0.003, 0.006, 0.002, and 0.020). Multivariate analysis showed that T stage, invasion of the nasal cavity, and nasal irrigation were influential factors for the incidence of sinusitis in NPC patients after IMRT (p = 0.002, 0.002, and 0.000). There was a higher incidence of sinusitis with higher T stage among NPC patients before radiotherapy, and the incidence of sinusitis in NPC patients after IMRT was high (45.2 %). The incidence of sinusitis increased rapidly within the first 3 months after IMRT, and the number of sinusitis cases peaked at 6-9 months after IMRT and showed a trend toward stabilization after 1 year. Advanced T stage, invasion of the nasal cavity, and nasal irrigation were positively associated with the incidence of sinusitis in NPC patients after IMRT.
authors.forename: Yan-xia
authors.initials: YX
authors.lastname: Su
authors.forename: Lan-ping
authors.initials: LP
authors.lastname: Liu
authors.forename: Lei
authors.initials: L
authors.lastname: Li
authors.forename: Xu
authors.initials: X
authors.lastname: Li
authors.forename: Xiu-juan
authors.initials: XJ
authors.lastname: Cao
authors.forename: Wei
authors.initials: W
authors.lastname: Dong
authors.forename: Xin-hua
authors.initials: XH
authors.lastname: Yang
authors.forename: Jin
authors.initials: J
authors.lastname: Xu
authors.forename: Shui
authors.initials: S
authors.lastname: Yu
authors.forename: Jun-fang
authors.initials: JF
authors.lastname: Hao
mesh_terms: D002277:Carcinoma; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009296:Nasal Cavity / Q000473:pathology*; D055556:Nasal Lavage / Q000009:adverse effects*; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000150:complications / Q000473:pathology / Q000532:radiotherapy; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012852:Sinusitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D014057:Tomography, X-Ray Computed