CAJ | 학술논문

目的探讨鼻咽癌患者调强放疗前后鼻窦炎的发生发展情况及影响因素.方法回顾分析2009-2011年间283例鼻咽癌患者调强放疗前后影像学资料,观察鼻窦炎发生发展情况.采用Logrank法单因素分析及Logistic法多因素分析其影响因素.结果放疗前T1、T2、T3、T4期鼻窦炎发生率分别为22.6％、37.5％、46.8％、61.3％ (P =0.002).放疗前无鼻窦炎的155例鼻咽癌患者放疗后1、3、6、9、12、18个月鼻窦炎发生率分别为32.9％、43.2％、61.3％、68.4％、73.5％、69.7％、61.3％ (P =0.000).单因素分析显示T分期、鼻腔受侵、鼻咽冲洗及鼻咽部照射剂量与调强放疗后鼻窦炎发生有关(P=0.003、0.006、0.002、0.020),多因素分析显示T分期、鼻腔受侵、鼻咽冲洗影响调强放疗后鼻窦炎发生(P =0.002、0.002、0.000).结论鼻咽癌患者放疗前鼻窦炎发生率随着T分期增高而增加,调强放疗后鼻窦炎在3个月内发生发展最快,9个月达高峰,1年后趋于稳定.T分期、鼻腔侵犯、鼻咽冲洗影响调强放疗后鼻窦炎的发生发展.
목적 탐토비인암환자조강방료전후비두염적발생발전정황급영향인소.방법 회고분석2009-2011년간283례비인암환자조강방료전후영상학자료,관찰비두염발생발전정황.채용Logrank법단인소분석급Logistic법다인소분석기영향인소.결과 방료전T1、T2、T3、T4기비두염발생솔분별위22.6％、37.5％、46.8％、61.3％ (P =0.002).방료전무비두염적155례비인암환자방료후1、3、6、9、12、18개월비두염발생솔분별위32.9％、43.2％、61.3％、68.4％、73.5％、69.7％、61.3％ (P =0.000).단인소분석현시T분기、비강수침、비인충세급비인부조사제량여조강방료후비두염발생유관(P=0.003、0.006、0.002、0.020),다인소분석현시T분기、비강수침、비인충세영향조강방료후비두염발생(P =0.002、0.002、0.000).결론 비인암환자방료전비두염발생솔수착T분기증고이증가,조강방료후비두염재3개월내발생발전최쾌,9개월체고봉,1년후추우은정.T분기、비강침범、비인충세영향조강방료후비두염적발생발전.
Objective To investigate the incidence of sinusitis in nasopharyngeal carcinoma (NPC) patients before and after intensity-modulated radiotherapy (IMRT) and analyze the influential factors for incidence of sinusitis after IMRT.Methods A retrospective analysis was performed on 283 NPC patients who received IMRT in our hospital from March 2009 to May 2011.CT or MRI scans were performed before and after IMRT to evaluate the incidence of sinusitis.The influential factors for incidence of sinusitis were analyzed by log-rank univariate analysis and logistic multivariate analysis.Results 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 (P =0.002).Among the 155 NPC patients without sinusitis before radiotherapy,the incidence rates of sinusitis at the end of radiotherapy and 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 (P =0.000).The univariate analysis showed that T stage,invasion into the nasal cavity,rhinopharynx flush,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).The multivariate analysis showed that T stage,invasion into the nasal cavity,and rhinopharynx flush were the influential factors for incidence of sinusitis in NPC patients after IMRT (P =0.002,0.002,and 0.000).Conclusions There is a higher incidence of sinusitis with higher T stage among NPC patients before radiotherapy.The incidence of sinusitis grows rapidly within 3 months after IMRT,reaches the peak level at 9 months,and tends to be stable at one year.T stage,invasion into the nasal cavity,and rhinopharynx flush are the influential factors for incidence of sinusitis in NPC patients after IMRT.