Radiation‐induced rhinosinusitis: Mechanism research and clinical progress review
Abstract Objectives Radiation‐induced rhinosinusitis is a vital dose‐limiting reaction in patients with head and neck malignancy. Unlike oral mucositis during or after radiotherapy, radiation‐induced sinusitis is easily overlooked in clinical practice and rarely included in experimental studies. Her...
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Wiley
2024-12-01
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| Series: | World Journal of Otorhinolaryngology-Head and Neck Surgery |
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| Online Access: | https://doi.org/10.1002/wjo2.134 |
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| author | Chunge Zheng Longgang Yu Yan Jiang |
| author_facet | Chunge Zheng Longgang Yu Yan Jiang |
| author_sort | Chunge Zheng |
| collection | DOAJ |
| description | Abstract Objectives Radiation‐induced rhinosinusitis is a vital dose‐limiting reaction in patients with head and neck malignancy. Unlike oral mucositis during or after radiotherapy, radiation‐induced sinusitis is easily overlooked in clinical practice and rarely included in experimental studies. Herein, we review the literature to date on radiation‐induced rhinosinusitis. Methods Relevant studies published between 1995 and 2022 were determined through a detailed search using open keywords from PubMed, with manual search of the reference list of the identified articles. Keywords searched were “ionizing radiation,” “radiotherapy,” “intensity‐modulated radiotherapy,” “head and neck tumor,” “nasopharyngeal carcinoma,” “nasal epithelium,” “radiation damage,” and “radiation‐induced rhinosinusitis.” Full‐text articles that clearly stated the pathogenesis, clinical manifestation, predictors, treatment, and prognosis of radiation‐induced rhinosinusitis were included. Results Radiation‐induced rhinosinusitis occurs during radiotherapy and can last for months or even years after radiotherapy. A mixture of cellular outcomes caused by ionizing radiation and persistent damage of the epithelial and submucosal tissues after the treatment result from the radiotherapy itself. Endoscopic sinus surgery improves symptoms but can be accompanied by intraoperative and postoperative complications. Nasal irrigation, steroids, and antibiotics appear to reduce inflammation and relieve symptoms to a certain extent. Studies on other potentially useful drugs are underway and in the exploration stage, without clinical application. Conclusions Despite its high incidence, radiation‐induced rhinosinusitis is a type of dose‐limiting toxicity that theoretically does not produce fatal effects at controlled doses and with adequate follow‐up care. In moderate‐to‐severe cases, toxicity may be present. Currently, radiation‐induced rhinosinusitis has potential prevention and treatment strategies. However, no unified management protocol has shown significant improvement in radiation‐induced rhinosinusitis. Further research is necessary. |
| format | Article |
| id | doaj-art-c17c93d625044c1391cea79883d15dca |
| institution | Kabale University |
| issn | 2095-8811 2589-1081 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | World Journal of Otorhinolaryngology-Head and Neck Surgery |
| spelling | doaj-art-c17c93d625044c1391cea79883d15dca2024-12-12T04:53:48ZengWileyWorld Journal of Otorhinolaryngology-Head and Neck Surgery2095-88112589-10812024-12-0110432433210.1002/wjo2.134Radiation‐induced rhinosinusitis: Mechanism research and clinical progress reviewChunge Zheng0Longgang Yu1Yan Jiang2Department of Otolaryngology, Head and Neck Surgery The Affiliated Hospital of Qingdao University Qingdao Shandong Province ChinaOtorhinolaryngology Head and Neck Surgery Key Laboratory of Shandong Province Qingdao Shandong Province ChinaDepartment of Otolaryngology, Head and Neck Surgery The Affiliated Hospital of Qingdao University Qingdao Shandong Province ChinaAbstract Objectives Radiation‐induced rhinosinusitis is a vital dose‐limiting reaction in patients with head and neck malignancy. Unlike oral mucositis during or after radiotherapy, radiation‐induced sinusitis is easily overlooked in clinical practice and rarely included in experimental studies. Herein, we review the literature to date on radiation‐induced rhinosinusitis. Methods Relevant studies published between 1995 and 2022 were determined through a detailed search using open keywords from PubMed, with manual search of the reference list of the identified articles. Keywords searched were “ionizing radiation,” “radiotherapy,” “intensity‐modulated radiotherapy,” “head and neck tumor,” “nasopharyngeal carcinoma,” “nasal epithelium,” “radiation damage,” and “radiation‐induced rhinosinusitis.” Full‐text articles that clearly stated the pathogenesis, clinical manifestation, predictors, treatment, and prognosis of radiation‐induced rhinosinusitis were included. Results Radiation‐induced rhinosinusitis occurs during radiotherapy and can last for months or even years after radiotherapy. A mixture of cellular outcomes caused by ionizing radiation and persistent damage of the epithelial and submucosal tissues after the treatment result from the radiotherapy itself. Endoscopic sinus surgery improves symptoms but can be accompanied by intraoperative and postoperative complications. Nasal irrigation, steroids, and antibiotics appear to reduce inflammation and relieve symptoms to a certain extent. Studies on other potentially useful drugs are underway and in the exploration stage, without clinical application. Conclusions Despite its high incidence, radiation‐induced rhinosinusitis is a type of dose‐limiting toxicity that theoretically does not produce fatal effects at controlled doses and with adequate follow‐up care. In moderate‐to‐severe cases, toxicity may be present. Currently, radiation‐induced rhinosinusitis has potential prevention and treatment strategies. However, no unified management protocol has shown significant improvement in radiation‐induced rhinosinusitis. Further research is necessary.https://doi.org/10.1002/wjo2.134head and neck cancersmucositisnasopharynx cancerradiation‐induced rhinosinusitisradiotherapy |
| spellingShingle | Chunge Zheng Longgang Yu Yan Jiang Radiation‐induced rhinosinusitis: Mechanism research and clinical progress review World Journal of Otorhinolaryngology-Head and Neck Surgery head and neck cancers mucositis nasopharynx cancer radiation‐induced rhinosinusitis radiotherapy |
| title | Radiation‐induced rhinosinusitis: Mechanism research and clinical progress review |
| title_full | Radiation‐induced rhinosinusitis: Mechanism research and clinical progress review |
| title_fullStr | Radiation‐induced rhinosinusitis: Mechanism research and clinical progress review |
| title_full_unstemmed | Radiation‐induced rhinosinusitis: Mechanism research and clinical progress review |
| title_short | Radiation‐induced rhinosinusitis: Mechanism research and clinical progress review |
| title_sort | radiation induced rhinosinusitis mechanism research and clinical progress review |
| topic | head and neck cancers mucositis nasopharynx cancer radiation‐induced rhinosinusitis radiotherapy |
| url | https://doi.org/10.1002/wjo2.134 |
| work_keys_str_mv | AT chungezheng radiationinducedrhinosinusitismechanismresearchandclinicalprogressreview AT longgangyu radiationinducedrhinosinusitismechanismresearchandclinicalprogressreview AT yanjiang radiationinducedrhinosinusitismechanismresearchandclinicalprogressreview |