Abstract
BackgroundThis study investigated the impact of post-radiation sinusitis on the prognosis of nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiation therapy (IMRT).MethodsTwo hundred and thirty patients with non-metastatic NPC were analyzed in terms of freedom from local failure (FFLF), freedom from distant failure (FFDF), overall survival (OS), and disease-free survival (DFS). For each patient, the status of the sinus mucosa was flexibly assessed by documenting mucosal changes as indicated by differences between images obtained before radiotherapy and more than 6 months post-radiation.ResultsWith a median follow-up of 39.7 months (8 to 81 months), 19 (8.26%) patients relapsed locally, 13 (5.65%) patients failed in the neck, and 26 (11.3%) patients developed distant metastases. The presence of sinusitis noted in images post-radiation was a significant predictor for DFS (p = 0.001), FFLF (p = 0.004), and FFDF (p = 0.015), in addition to having high negative predictive value for local relapse (97.5%).ConclusionsThis is the first study to investigate the prognostic value of post-radiation sinusitis in NPC patients treated with IMRT. Post-radiation sinusitis was found to be a significant predictor for DFS, FFLF, and FFDF, and was also found to have high negative predictive value for local recurrence (97.5%). It may thus be used as an additional tool for clinicians to determine the possibility of recurrence.
Highlights
This study investigated the impact of post-radiation sinusitis on the prognosis of nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiation therapy (IMRT)
The T stage is still the most well recognized prognostic factor, Huang et al Radiation Oncology (2019) 14:61 while tumor volume is a somewhat controversial predictor of local recurrence and cutoff volume is still being investigated with regard to its predictive value [8, 9, 11, 12]
Epstein-Barr virus (EBV) DNA is helpful for surveillance [13,14,15]; the quantitative methods used in each laboratory are different, and the interpretation criteria vary for every facility
Summary
This study investigated the impact of post-radiation sinusitis on the prognosis of nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiation therapy (IMRT). Clinicians are making ongoing efforts to discover useful prognostic factors in this new IMRT era, given that IMRT has already been shown to have different dosimetric characteristics than three-dimensional conformal radiation therapy (3D-CRT). The T stage is still the most well recognized prognostic factor, Huang et al Radiation Oncology (2019) 14:61 while tumor volume is a somewhat controversial predictor of local recurrence and cutoff volume is still being investigated with regard to its predictive value [8, 9, 11, 12]. Practitioners are making efforts to investigate new available and useful prognostic factors for the purposes of surveillance after treatment
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