Application Of Head And Neck Axial Rotation Angle Measuring Device In The Evaluation Of Cervical Fibrosis After Radiotherapy For Nasopharyngeal Carcinoma

Objective1.To assess the axial rotation angle of the head and neck in nasopharyngeal carcinoma patients post-radiotherapy,and investigate its correlation with CTCAE fibrosis classification and neck fibrosis area,thereby evaluating its feasibility and clinical applicability.2.To investigate the correlation between axial rotation angle of the neck and lower cranial nerve injury in nasopharyngeal carcinoma patients after radiotherapy,as well as to analyze related risk factors for such injuries,thereby providing a theoretical basis for intervention strategies.MethodsFrom August 2019 to December 2021,patients with nasopharyngeal carcinoma who had received intensity-modulated radiotherapy for more than 1 year were consecutively selected from the outpatient department of Jiangxi Provincial Cancer Hospital.The axial rotation Angle of the left and right neck was measured by the head and neck axial rotation Angle measuring device.At the same time,the left and right neck fibrosis was graded by CTCAE,the area of the left and right neck fibrosis was measured,and the injury of the posterior cranial nerve was evaluated.Bivariate correlation analysis was used to analyze the axial rotation Angle of the contralateral neck,the CTCAE fibrosis grade of the contralateral neck and the area of the contralateral neck fibrosis.ROC curves were used for diagnostic tests.Results1.A total of 285 patients were enrolled in the study.The median values of the axial rotation angles of the left and right sides of the neck were 50°(20° ～ 70°)and45°(15° ～ 70°),respectively.The incidence rates of CTCAE fibrosis above grade 1were 24.91%(71/285)and 20.35%(58/285),respectively.The median fibrosis area on the left and right sides was 15cm2(0cm2 ～ 90cm2)and 12cm2(0cm2 ～ 105cm2),respectively.The incidence of cranial nerve injury in the left and right posterior groups was 8.07%(23/285)and 10.18%(29/285),respectively.2.The axial rotation Angle of the neck was negatively correlated with the CTCAE fibrosis grade of the contralateral neck,the fibrosis area of the contralateral neck,and the injury of the contralateral posterior cranial nerves.3.In the posterior cranial nerve injury group,the CTCAE fibrosis grade and the area of fibrosis in the ipsilateral neck were higher than those in the non-injury group.The axial rotation Angle of contralateral neck in patients with posterior cranial nerve injury was smaller than that in patients without posterior cranial nerve injury.4.The combination of lateral neck axial rotation Angle,ipilateral neck CTCAE fibrosis grade and ipilateral neck fibrosis area predicted cranial nerve injury better than single prediction,which is helpful for early prediction of cranial nerve injury in the posterior group.ConclusionThe measurement results obtained from the simple head axial rotation protractor can provide a relatively accurate reflection of the degree of neck soft tissue fibrosis,thereby facilitating the prediction of posterior cranial nerve injury occurrence.