Factors related with development of treatment induced trismus in nasopharyngeal cancer patients

Abstract

OBJECTIVES Our objective is to analyse the rate of trismus induced after treatment for nonmetastatic nasopharyngeal cancer patients and to assess the factors on development of it. METHODS The files of 292 patients with more than two years follow-up between November 1993-2001 were investigated retrospect ively. The patient related factors (gender, age), tumor related factors (stage, histopathological diagnosis, trismus at the time of diagnosis, cranial nerve involvement), tretment related factors (radiotherapy with or without concomittan chemotherapy, applying brachitherapy or not, total treatment time and radiotherapy dose, applying reirradiation or not) were registered and effect of these factors to formation of trismus was investigated. RESULTS The rate of trismus was found to be 8%. Two and five-year overall survival rates were 83% and 67.6%. Among investigated factors only two were found related with formation of radiation induced trismus: presence of trismus at the time of diagnosis (p=0.03) and treatment with reirradiation for recurrence (p=0.002). CONCLUSION In this study radiation induced trismus rate for nasopharyngeal cancer was similar to findings in literature. Trismus at the time of diagnosis and reirradiation are factors effecting the rate of observing this complication.

Keywords

• Nasopharyngeal Neoplasms,Radiotherapy, High-Energy,Trismus,Survival,Adverse effects

Nazofarenks kanserli hastalarda geç yan etki olarak ortaya çıkan trismus gelişimine etkili faktörler

Öz

AMAÇ Çalışmada nazofarenks karsinomlu (NFK) hastalarda radyoterapi (RT) sonrası geç yan etki olarak ortaya çıkan trismus oranı araştırılarak gelişiminde etkili olabilecek faktörler ele alındı. GEREÇ VE YÖNTEM Aralık 1993-2003 tarihleri arasında NFK tanısıyla küratif olarak tedavi edilen 292 hasta çalışmaya alındı. Hastalara ait özellikler (cinsiyet, yaş), tümörlerine ait özellikler (evre, histopatolojik tanı, tanı anında trismus varlığı, kraniyal sinir tutulumu), tedaviye ait özellikler (radyoterapinin konkomittan olup olmaması, brakiterapi uygulanıp uygulanmaması, tedavi süresi ve dozu, ikinci seri ışınlama uygulanıp uygulanmaması) kaydedildi ve bu faktörlerin trismus gelişimine etkisi araştırıldı. BULGULAR İki ve beş yıllık genel sağkalım sırası ile %83 ve %67.6 olarak bulundu. Hastalarda takipte trismus görülme oranı %8 olarak saptandı. İncelenen faktörlerden sadece tanı anında trismus olması (p=0.03) ve hastalara birden fazla radyoterapi uygulanması (p=0.002) trismus gelişimini artırmaktadır. SONUÇ Bu çalışmada NFK tanılı hastalarda tedavi sonu trismus görülme oranı literatürle uyumlu bulundu. Hastalarda tanı anında trismus varlığı ve ikinci seri ışınlama uygulanması bu komplikasyonun görülme olasılığını artırmaktadır.

Anahtar Kelimeler

• Karsinom/patoloji/tedavi, nazofarenks neoplazi/patoloji/tedavi, radyoterapi, yüksek enerjili, trismus

Kaynakça

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