Post-Irradiation Sinus Mucosa Disease in Nasopharyngeal Carcinoma Patients Treated with Intensity-Modulated Proton Therapy

被引：19

作者：

Wu, Pei-Wen ^{[1
,2
,3
,4
]}

Huang, Chien-Chia ^{[1
,2
,5
]}

Lee, Yun-Shien ^{[6
,7
]}

Chou, Yung-Chih ^{[8
,9
]}

Fan, Kang-Hsing ^{[8
]}

Lin, Chien-Yu ^{[8
]}

Huang, Bing-Shen ^{[8
]}

Yang, Shih-Wei ^{[3
,4
,5
]}

Huang, Chi-Che ^{[1
,2
,5
]}

Chang, Po-Hung ^{[1
,2
,5
]}

Lee, Ta-Jen ^{[1
,2
]}

Chang, Joseph Tung-Chieh ^{[2
,8
]}

机构：

[1] Chang Gung Mem Hosp, Div Rhinol, Dept Otolaryngol, Taoyuan 333, Taiwan

[2] Chang Gung Univ, Taoyuan 333, Taiwan

[3] Chang Gung Mem Hosp, Dept Otolaryngol Head & Neck Surg, Keelung 204, Taiwan

[4] Chang Gung Univ, Keelung 204, Taiwan

[5] Chang Gung Univ, Grad Inst Clin Med Sci, Coll Med, Taoyuan 333, Taiwan

[6] Chang Gung Mem Hosp, Genom Med Res Core Lab, Taoyuan 333, Taiwan

[7] Ming Chuan Univ, Dept Biotechnol, Taoyuan 333, Taiwan

[8] Chang Gung Mem Hosp, Dept Radiat Oncol, Taoyuan 333, Taiwan

[9] New Taipei Municipal Tucheng Hosp, Dept Radiat Oncol, New Taipei 236, Taiwan

来源：

CANCERS | 2022年 / 14卷 / 01期

关键词：

nasopharyngeal carcinoma; post-irradiation sinusitis; sinus mucosa disease; proton therapy; QUALITY-OF-LIFE; COMPUTED-TOMOGRAPHY; PARANASAL SINUSES; RADIOTHERAPY; NASAL; ABNORMALITIES; RHINOSINUSITIS; CHEMOTHERAPY; CT;

D O I：

10.3390/cancers14010225

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Simple Summary Chronic rhinosinusitis (CRS) is a common treatment complication in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. In this study, we aimed to investigate the incidence and severity of CRS in NPC patients who underwent intensity-modulated proton therapy (IMPT) by evaluating the sinus mucosa change in imaging studies, and we compared these patients with those who underwent volume-modulated arc therapy (VMAT). This was a retrospective case-control study in which 53 and 54 patients were treated with IMPT and VMAT, respectively. We noted that patients in the IMPT group had a significantly lower incidence and decreased severity of sinus mucosa abnormality than those with VMAT. Better and faster recovery of sinonasal function after radiotherapy in the IMPT group was also observed. IMPT techniques deposit the bulk of their radiation doses in highly confined areas, allowing lower exposure of non-target organs during irradiation, which results in more sinonasal mucosa being retained. In the past decade, patients with nasopharyngeal cancer (NPC) have been deemed candidates for proton radiotherapy, due to the large and comprehensive target volumes and the necessity for the retention of the surrounding healthy tissues. In this study, we aimed to compare the incidence and severity of post-irradiation sinusitis by detecting sinus mucosa diseases (SMDs) via the magnetic resonance imaging (MRI) of patients with NPC after intensity-modulated proton therapy (IMPT) and volume-modulated arc therapy (VMAT). A total of 53 patients in the IMPT group and 54 patients in the VMAT group were enrolled in this study. There were significantly lower endoscopic scores and Lund-Mackay staging scores determined from MRI scans in the IMPT group during different follow-up periods. For the most vulnerable sinuses, the incidence and severity of SMD were the highest during the third post-radiotherapy month in both groups. These decreased steadily, and there was no significant increase in the incidence and severity of SMD during the second post-radiotherapy year in the IMPT group. Our data show that NPC patients with IMPT have a significantly lower incidence and decreased severity of SMD than those with VMAT. A better and faster recovery of sinonasal function after radiotherapy in the IMPT group was also observed.

引用

页数：10

共 37 条

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