Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-20T12:31:37.877Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of intranasal steroids on rhinosinusitis after radiotherapy for nasopharyngeal carcinoma: clinical study

Published online by Cambridge University Press:  07 January 2016

S Feng ,
Y Fan ,
Z Liang ,
G Yang ,
Z Liao  and
L Guo
S Feng
Affiliation:
Department of Otolaryngology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
Y Fan*
Affiliation:
Department of Otolaryngology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
Z Liang
Affiliation:
Department of Radiation Oncology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
G Yang
Affiliation:
Department of Radiation Oncology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
Z Liao
Affiliation:
Department of Otolaryngology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
L Guo
Affiliation:
Department of Otolaryngology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
*
Address for correspondence: Dr Yunping Fan, Department of Otolaryngology, Fifth Affiliated Hospital of Sun Yat-sen University, No 52, Meihua East Road, Xiangzhou District, Zhuhai, China519000 Fax: 86 0756 2261253 E-mail: zhfanyp@163.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Post-irradiation rhinosinusitis is one of the most common untoward side effects in patients with nasopharyngeal carcinoma. This study aimed to evaluate the effect of fluticasone propionate aqueous nasal spray on post-irradiation rhinosinusitis.

Methods:

Nasopharyngeal carcinoma patients who had undergone radiotherapy and subsequently developed chronic rhinosinusitis were randomised to receive either fluticasone propionate aqueous nasal spray 200 µg plus nasal irrigation or a single nasal irrigation, for six months. A questionnaire, nasal endoscopy and computed tomography were used to evaluate rhinosinusitis severity, at the beginning of treatment, and at three and six months after treatment.

Results:

The group who received fluticasone propionate aqueous nasal spray combined with irrigation had fewer nasal complaints (overall symptoms, blocked nose and headache were reduced), a better quality of life and less severe endoscopic findings than those who only received nasal irrigation at three and six months after treatment.

Conclusion:

Nasal steroids are a safe and effective therapy for patients with post-irradiation rhinosinusitis.

Keywords

SinusitisNasopharyngeal CarcinomaSteroidsRadiotherapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 3 , March 2016 , pp. 265 - 271
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Wee, JT, Ha, TC, Loong, SL, Qian, CN. Is nasopharyngeal cancer really a “Cantonese cancer”? Chin J Cancer 2010;29:517–26CrossRefGoogle ScholarPubMed
2Porter, MJ, Leung, SF, Ambrose, R, Cheung, HS, van Hasselt, CA. The paranasal sinuses before and after radiotherapy for nasopharyngeal carcinoma: a computed tomographic study. J Laryngol Otol 1996;110:19–22CrossRefGoogle ScholarPubMed
3Payne, DG. Carcinoma of the nasopharynx. J Otolaryngol 1983;12:197–203Google ScholarPubMed
4Zubizarreta, PA, D'Antonio, G, Raslawski, E, Gallo, G, Preciado, MV, Casak, SJ et al. Nasopharyngeal carcinoma in childhood and adolescence: a single-institution experience with combined therapy. Cancer 2000;89:690–53.0.CO;2-S>CrossRefGoogle ScholarPubMed
5Lou, PJ, Chen, WP, Tai, CC. Delayed irradiation effects on nasal epithelium in patients with nasopharyngeal carcinoma: an ultrastructural study. Ann Otol Rhinol Laryngol 1999;108:474–80CrossRefGoogle ScholarPubMed
6Civantos, FJ Jr, Yoskovitch, A, Casiano, RR. Endoscopic sinus surgery in previously irradiated patients. Am J Otolaryngol 2001;22:100–6CrossRefGoogle ScholarPubMed
7Su, MC, Jiang, RS, Chiang, JL, Lin, JC. Endoscopic sinus surgery for the treatment of chronic rhinosinusitis in patients with postirradiated nasopharyngeal carcinoma. Am J Otolaryngol 2006;27:46–9CrossRefGoogle ScholarPubMed
8Hu, KH, Tan, CT, Lin, KN, Cheng, YJ, Huang, HM. Effect of endoscopic sinus surgery on irradiation-induced rhinosinusitis in patients with nasopharyngeal carcinoma. Otolaryngol Head Neck Surg 2008;139:575–9CrossRefGoogle ScholarPubMed
9Piccirillo, JF, Merritt, MG Jr, Richards, ML. Psychometric and clinimetric validity of the 20-Item Sino-Nasal Outcome Test (SNOT-20). Otolaryngol Head Neck Surg 2002;126:41–7CrossRefGoogle ScholarPubMed
10Lund, VJ, Kennedy, DW. Staging for rhinosinusitis. Otolaryngol Head Neck Surg 1997;117:35–40CrossRefGoogle ScholarPubMed
11Lund, VJ, Mackay, IS. Staging in rhinosinusitis. Rhinology 1993;31:183–4Google Scholar
12Huang, CC, Huang, SF, Lee, TJ, Ng, SH, Chang, JT. Postirradiation sinus mucosa disease in nasopharyngeal carcinoma patients. Laryngoscope 2007;117:737–42CrossRefGoogle ScholarPubMed
13Nicolatou-Galitis, O, Sarri, T, Bowen, J, Di Palma, M, Kouloulias, VE, Niscola, P et al. Systematic review of anti-inflammatory agents for the management of oral mucositis in cancer patients. Support Care Cancer 2013;21:3179–89CrossRefGoogle ScholarPubMed
14Sonis, ST, Peterson, RL, Edwards, LJ, Lucey, CA, Wang, L, Mason, L et al. Defining mechanisms of action of interleukin-11 on the progression of radiation-induced oral mucositis in hamsters. Oral Oncol 2000;36:373–81CrossRefGoogle ScholarPubMed
15Kamel, R, Al-Badawy, S, Khairy, A, Kandil, T, Sabry, A. Nasal and paranasal sinus changes after radiotherapy for nasopharyngeal carcinoma. Acta Otolaryngol 2004;124:532–5CrossRefGoogle ScholarPubMed
16Deng, ZY, Tang, AZ. Bacteriology of postradiotherapy chronic rhinosinusitis in nasopharyngeal carcinoma patients and chronic rhinosinusitis. Eur Arch Otorhinolaryngol 2009;266:1403–7CrossRefGoogle ScholarPubMed
17Heatley, DG, McConnell, KE, Kille, TL, Leverson, GE. Nasal irrigation for the alleviation of sinonasal symptoms. Otolaryngol Head Neck Surg 2001;125:44–8CrossRefGoogle ScholarPubMed
18Tomooka, LT, Murphy, C, Davidson, TM. Clinical study and literature review of nasal irrigation. Laryngoscope 2000;110:1189–93CrossRefGoogle ScholarPubMed
19Liang, KL, Kao, TC, Lin, JC, Tseng, HC, Su, MC, Hsin, CH et al. Nasal irrigation reduces postirradiation rhinosinusitis in patients with nasopharyngeal carcinoma. Am J Rhinol 2008;22:258–62CrossRefGoogle ScholarPubMed
20Snidvongs, K, Kalish, L, Sacks, R, Craig, JC, Harvey, RJ. Topical steroid for chronic rhinosinusitis without polyps. Cochrane Database Syst Rev 2011;(10):CD009274Google ScholarPubMed
21Levenson, T, Greenberger, PA. Immunologic effects of intranasal corticosteroids. Allergy Asthma Proc 1996;17:157–9CrossRefGoogle ScholarPubMed
22Hwang, PH, Irwin, SB, Griest, SE, Caro, JE, Nesbit, GM. Radiologic correlates of symptom-based diagnostic criteria for chronic rhinosinusitis. Otolaryngol Head Neck Surg 2003;128:489–96Google ScholarPubMed
23Bachert, C, Hormann, K, Mosges, R. An update on the diagnosis and treatment of sinusitis and nasal polyposis. Allergy 2003;58:176–91CrossRefGoogle ScholarPubMed
24Okuyemi, KS, Tsue, TT. Radiologic imaging in the management of sinusitis. Am Fam Physician 2002;66:1882–6Google ScholarPubMed