Presentation 頭頸部腫瘍に対する炭素イオン線治療後の口腔-鼻副鼻腔農瘻の危険因子に関する研究

小藤, 昌志

Purpose: The purpose of this study is to determine the risk factors for developing radiation-induced radiation-induced oroantral or oronasal fistula after carbon-ion radiotherapy.Materials and Methods: Sixty-two patients with oral or sinonasal tumors who were followed up more than 5 years after carbon-ion radiotherapy were included in this study. Thirty patients had nasal tumors, 20 paranasal tumors, and 12 oral tumors. Regarding the histology, 29 patients had mucosal melanoma, 22 adenoid cystic carcinoma, 11 others. Fifteen tumors invaded maxilla. Carbon-ion radiotherapy was delivered to 57.6 Gy (RBE)/16 fractions in 32 patients and 64.0 Gy (RBE)/16 fractions in 30 patients. The clinical factors for the radiation-induced oroantral or oronasal fistula were analyzed using multivariate logistic regression model. Results: The median follow up period was 88.8 months (range; 60.6-120.7 months). Twenty-three patients (37%) developed the radiation-induced oroantral or oronasal fistula. Multivariate logistic regression analysis showed that maxillary invasion and number of the teeth in the volume receiving more than 50 Gy (RBE) were significant risk factors (p = 0.016 odds ratio 53.9 95% confidence interval [CI] 2.1-1381.0, p = 0.01 odds ratio 2.45% CI 1.2-4.6, respectively).Conclusions: Maxillary invasion was the strongest predictive factor for developing oroantral or oronasal fistula.

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