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Correlation of intensity-modulated radiation therapy at a specific radiation dose with the prognosis of nasal mucous damage after radiotherapy

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Abstract

Objective of the present study was to investigate the tolerant radiation dose of nasal mucosa by observing and analyzing patients who received intensity-modulated radiation therapy (IMRT). Patients with nasopharyngeal carcinoma (N = 66) were selected for this study. The modified saccharin assay, endoscopy test, magnetic resonance imaging, and sino-nasal outcome test-20 (SNOT-20) survey were performed for the patients before and at 0 (T0), 3 (T1), 6 (T2), and 12 (T3) months after radiotherapy. The threshold doses of IMRT before radiotherapy and at T0, T1, T2, and T3 were determined as, respectively, 37 Gy, 37 Gy, 39 Gy, and 37 Gy for the saccharin test; 38 Gy, 37 Gy, 40 Gy, and 38 Gy for the endoscopy test; and 39 Gy, 37 Gy, 39 Gy, and 39 Gy for the nasal-related symptom scoring test. The modified saccharin assay, endoscopy test, and SNOT-20 survey revealed that a low dose (< threshold dose) of IMRT was associated with higher mucocilia transport rate (MRT), better endoscopy test score, and improved SNOT-20 score. The patients who received IMRT at a dose less than the threshold had the least damaged nasal mucosa morphology, and functional impairment scores were highest at T1 of IMRT. We conclude that nasal mucosa showed the most serious damage within 3 months after IMRT. If the radiation dose can be controlled within the threshold, the nasal mucosa can recover in the following few months, but recovery will be difficult otherwise.

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Acknowledgements

This study was supported by the Project of Administration of Traditional Chinese Medicine of Guangdong Province of China (No. 20191088) and the Fundamental Research Funds for the Central Universities (No. 21619359).

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  1. Gendi Yin and Bo Tu have equally contributed to this paper.

Authors and Affiliations

  1. Department of Otolaryngology and Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China

    Gendi Yin

  2. Department of Otolaryngology and Head and Neck Surgery, The First Affiliated Hospital of Ji Nan University, Guangzhou, 510632, Guangdong, China

    Bo Tu

  3. Department of Oncology, The First Affiliated Hospital of Ji Nan University, No. 613 Huang Pu Road west, Guangzhou, 510632, Guangdong, China

    Ling Ye

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  1. Gendi Yin
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Correspondence to Ling Ye.

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Yin, G., Tu, B. & Ye, L. Correlation of intensity-modulated radiation therapy at a specific radiation dose with the prognosis of nasal mucous damage after radiotherapy. Radiat Environ Biophys 59, 245–255 (2020). https://doi.org/10.1007/s00411-020-00830-5

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