Nasosinusitis After Radiotherapy For Head And Neck Cancer:a Clinical Analysis

Objective:To analysis factors and clinical characteristics of nasosinusitis after radiotherapy for head and neck malignant tumor, and discusses the prevention, treatment measures of secondary sinusitis after radiotherapy.Methods:A retrospective evaluation of 86 consecutive patients with head and neck malignant tumor target areas (including some sinus) before and after radiotherapy for head and neck. The incidence and influencing factors of nasosinusitis were analyzed using logistic regression model. Moreover, statistical analysis used SPSS 17.0 software.Results:86 cases of head and neck malignant tumour patients,16 cases (19%) with sinusitis before radiotherapy, and 55 cases (64%) with sinusitis after radiotherapy. Compared with the group without nasosinusitis, patients in the group with nasosinusitis had a higher T stage (96% vs.59%, P<0.05), higher incidence in tumor invasion of nasal cavity (42% vs.18%, P<0.05), and a lower incidence of nasal wash therapy (75% vs.94%, P<0.05). Univariable and multivariable logistic regression analysis showed that age(years)、male(%)、lymph node metastasis and using nasal drop were not associated with nasosinusitis. However, nasosinusitis was related to the higher T stage [odds ratio (OR)=1.86,95%confidence interval (CI):1.20-2.80, P< 0.05] and the tumor invasion of nasal cavity (OR=2.09,95%CI:1.10-3.98, P< 0.05). Using nasal wash therapy both during and after radiotherapy could reduce the risk of nasosinusitis (OR=0.22,95%CI:0.11-0.59, P<0.05). Additionally, among patients with sinusitis before radiotherapy, the sinusitis of the vast majority patients after radiotherapy is not improved. CT images showed that only 4 cases with sinusitis were observed the better condition. There was no statistically significant difference in comparison before and after treatment (P>0.05), and even condition in some patients was worse.18 patients with long-term intranasal application of nosebleed tube contraction agent (continuous use at least 1 month or more) cause rhinitis related medicaments.Conclusion:The higher T stage, the tumor invasion of nasal cavity and using nasal wash therapy were independent risk factors for nasosinusitis after radiotherapy for head and neck cancer. When the patients have the higher T stage and the tumor invasion of nasal cavity, nasal wash therapy for 6 months should be considered to lower the incidence of nasosinusitis after radiotherapy for head and neck cancer, relieve symptoms of nasosinusitis, and improve life quality of patients.