Chronic rhinosinusitis in nasopharyngeal carcinoma patients post- IMRT: a meta-analysis.

IF 4.8 2区医学 Q1 OTORHINOLARYNGOLOGY

Rhinology Pub Date : 2025-05-23 DOI:10.4193/Rhin25.095

N Y M Chua, W K Lau, A L Chui, C L Ng, D Y Wang

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引用次数: 0

Abstract

Background: Intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) can cause chronic rhinosinusitis (CRS), an underexplored side effect. This review aimed to determine the incidence and severity of CRS in NPC patients post-IMRT.

Methods: Electronic databases (PubMed, CINAHL, Embase, Cochrane Library, Web of Science) were searched for studies published from 2000 onwards. Eligible studies assessed CRS in NPC patients post-IMRT, using validated methods per EPOS 2020 (Lund-Mackay (LM) CT scoring, Lund-Kennedy (LK) endoscopic scoring, SNOT questionnaire). Meta-analysis was conducted using SPSS and R to quantify pooled CRS incidence and severity.

Results: Nine studies (n=1,478) were included, revealing distinct patterns in CRS development and severity. Patients without prior sinusitis showed significantly increased likelihood of developing CRS post-IMRT, while those with prior sinusitis had reduced odds due to a ceiling effect, as CRS was already present in 100% of these patients before IMRT. Both groups showed significant increases in CRS severity pre- and post-IMRT, with the LK and LM scoring methods showing the most substantial changes.

Conclusions: This review underscores the significant increases in both the incidence and severity of CRS in NPC patients post- IMRT. Clinicians should recognise the risk of CRS post-IMRT and recommend options to reduce the likelihood of CRS development.

查看原文本刊更多论文

鼻咽癌患者IMRT后慢性鼻窦炎：一项荟萃分析。

背景：调强放疗（IMRT）治疗鼻咽癌（NPC）可引起慢性鼻窦炎（CRS），这是一个未被充分研究的副作用。本综述旨在确定鼻咽癌患者imrt后CRS的发生率和严重程度。方法：检索电子数据库（PubMed， CINAHL, Embase, Cochrane Library, Web of Science） 2000年以来发表的研究。符合条件的研究评估了鼻咽癌患者imrt后的CRS，使用epos2020（隆德-麦凯（LM） CT评分、隆德-肯尼迪（LK）内窥镜评分、SNOT问卷）的验证方法。采用SPSS和R进行meta分析，量化合并的CRS发生率和严重程度。结果：纳入了9项研究（n= 1478），揭示了CRS发展和严重程度的不同模式。没有鼻窦炎病史的患者在IMRT后发生CRS的可能性显著增加，而有鼻窦炎病史的患者由于天花板效应而发生CRS的可能性降低，因为这些患者在IMRT前已经100%存在CRS。两组患者在imrt前后的CRS严重程度均有显著增加，其中LK和LM评分方法的变化最为显著。结论：本综述强调了鼻咽癌患者IMRT后CRS的发生率和严重程度的显著增加。临床医生应该认识到imrt后CRS的风险，并推荐减少CRS发生可能性的方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rhinology 医学-耳鼻喉科学

CiteScore

15.80

自引率

9.70%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Rhinology serves as the official Journal of the International Rhinologic Society and is recognized as one of the journals of the European Rhinologic Society. It offers a prominent platform for disseminating rhinologic research, reviews, position papers, task force reports, and guidelines to an international scientific audience. The journal also boasts the prestigious European Position Paper in Rhinosinusitis (EPOS), a highly influential publication first released in 2005 and subsequently updated in 2007, 2012, and most recently in 2020. Employing a double-blind peer review system, Rhinology welcomes original articles, review articles, and letters to the editor.