基于MRI和IMRT的鼻咽癌鼻窦侵犯的预后研究

doi:10.3760/cma.j.issn.1004-4221.2016.01.003

Abstract
Figure/Table
References()
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (1401 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract Objective To identify the prognostic value of paranasal sinus involvement based on magnetic resonance imaging (MRI) findings in the staging of nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). Methods The clinical data of 1179 patients who were initially diagnosed with NPC by MRI and received IMRT from 2005 to 2010 were analyzed retrospectively, and staging was performed for these patients again according to the American Joint Committee on Cancer (AJCC) staging system. Paranasal sinus involvement was classified into T₃ stage with paranasal sinus involvement and T₄ stage with paranasal sinus involvement. Overall survival (OS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were calculated by the Kaplan-Meier method, and the log-rank test was used for survival difference analysis. The Cox regression model was used to investigate the independent prognostic factors and the hazard ratios for local relapse in each T group. Results The rate of paranasal sinus involvement was 14.2%, and paranasal sinus involvement was not an independent prognostic factor for OS, LRFS, or DMFS of NPC patients (P=0.677,0.485,0.211). The patients in T₂ stage, T₃ stage with paranasal sinuses involvement, and T₃ stage without paranasal sinuses involvement had similar hazard ratios for local relapse (HR=1.927,2.030,2.283), and the three groups of patients also had similar LRFS and OS curves (P>0.05), which were significantly different from those of the patients in T₄ stage with paranasal sinus involvement and T₄ stage without paranasal sinus involvement (P<0.05). Conclusions Paranasal sinus involvement is not an independent prognostic factor for OS, LRFS, or DMFS in NPC treated with IMRT;however, the patients in T₃ stage with paranasal sinus involvement have similar LRFS and OS as those in T₂ and T₃ stages, and have better prognosis than those in T₄ stage.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Key words： Nasopharyngeal neoplasms/intensity-modulated radiotherapy Magnetic resonance imaging neoplasms involvement Paranasal sinus

Received: 17 November 2014

About author:: Chen Yunbin,Email:Yunbinchen@126.com

Cite this article:

. The prognostic value of paranasal sinus involvement based on MRI in nasopharyngeal carcinoma treated with intensity-modulated radiotherapy[J]. Chinese Journal of Radiation Oncology, 2016, 25(1): 9-13.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2016.01.003 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2016/V25/I1/9

[1]Pharynx (Including base of tongue,soft palate,and uvula)[A]//Greene FL,Compton CC,Fritz AG,et al. AJCC cancer staging atlas[M]. New York:Springer,2010:27-39.DOI:10.1007/ 0-387-33126-3_4.
[2]中国鼻咽癌临床分期工作委员会. 鼻咽癌’92分期修订工作报告[J]. 中华放射肿瘤学杂志,2009,18(1):2-6.DOI:10.3760/cma.j. issn.1004-4221.2009.01.002.
China working committee on clinical staging of nasopharyngeal carcinoma.′92 staging for nasopharyngeal carcinoma revision report[J].Chin J Radit Oncol,2009,18(1):2-6.DOI:10.3760/ cma.j.issn.1004-4221.2009.01.002.
[3]Chen L,Mao YP,Xie FY,et al. The seventh edition of the UICC/AJCC staging system for nasopharyngeal carcinoma is prognostically useful for patients treated with intensity-modulated radiotherapy from an endemic area in China[J]. Radiother Oncol,2012,104(3):331-337.DOI:10.1016/ j. radonc.2011.10.009.
[4]Pan JJ,Xu YJ,Qiu SF,et al. A comparison between the Chinese 2008 and the 7^th edition AJCC staging systems for nasopharyngeal carcinoma[J]. Am J Clin Oncol,2015,38(2):189-196.DOI:10.1097/COC.0b013e31828f5c96.
[5]Ng SH,Chang TC,Ko SF,et al. Nasopharyngeal carcinoma:MRI and CT assessment[J]. Neuroradiology,1997,39(10):741-746.DOI:10.1007/s002340050499.
[6]Chang VF,Fan YF,Khoo JB. Computed tomographic and magnetic resonance imaging finding in paranasal sinus involvement in nasopharyngeal carcinoma[J].Ann Acad Med Singapore, 1998,27(6):800-804.
[7]Lee N,Xia P,Quivey JM,et al. Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma:an update of the UCSF experience[J]. Int J Radiat Oncol Biol Phys, 2002,53(1):12-22.DOI:10.1016/S0360-3016(02)02724-4.
[8]Lin SJ,Pan JJ,Han L,et al. Update report of nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiation therapy and hypothesis of the optimal margin[J]. Radiother Oncol,2014,110(3):385-389.DOI:10.1016/j.radonc. 2014.01.011.
[9]陈韵彬,方燕红,陈英,等. 鼻咽癌侵犯周围结构与肿瘤分期关系的MRI研究[J]. 中华放射学杂志,2010,44(10):1024-1029. DOI:10. 3760/cma.j.issn.1005-1201.2010.10.004.
Chen YB,Fang YH,Chen Y,et al. MRI study of tumor staging and nasopharyngeal carcinoma invading adjacent structures[J]. Chin J Radiol,2010,44(10):1024-1029.DOI:10.3760/cma.j.issn. 1005-1201.2010.10.004.
[10]刘妍,梁赵玉,于小平,等. 鼻咽癌侵犯鼻窦的MRI表现(附86例病例分析)[J]. 放射学实践,2010,25(10):1100-1102.DOI:10.3969/ j.issn.1000-0313.2010.10.012.
Liu Y, Liang ZY,Yu XP,et al. MRI of nasopharyngeal carcinoma invading the paranasal sinuses (analysis of 86 cases)[J]. Radiol Pract,2010,25(10):1100-1102.DOI:10.3969/j.issn.1000-0313.2010.10.012.
[11]谢传淼,梁碧玲,林浩皋,等. MRI对鼻咽癌T、N分期的影响[J]. 中华肿瘤杂志,2002,24(2):181-184.
Xie CM,Liang BL,Lin HG,et al. Effect of MRI on T,N-staging of nasopharyngeal carcinoma[J].Chin J Oncol,2002,24(2):181-184.
[12]Lee AWM,Sze WM,Au JSK,et al. Treatment results for nasopharyngeal carcinoma in the modern era:the Hong Kong experience[J]. Int J Radiat Oncol Biol Phys,2005,61(4):1107-1116. DOI:10.1016/j.ijrobp.2004.07.702.
[13]毛燕萍,洪明晃,孙颖,等. 基于磁共振成像鼻咽癌临床分期的研究——对’92分期改进的建议[J]. 癌症,2007,26(10):1099-1106. DOI:10.3321/j.issn:1000-467x.2007.10.012.
Mao YP,Hong MH,Sun Y,et al. Study of clinical staging of nasopharyngeal carcinoma based on magnetic resonance imaging —′92 staging suggestions for improvement[J].Chin J Cancer, 2007,26(10):1099-1106.DOI:10.3321/j.issn:1000-467x.2007.10.012.
[14]Liao XB,Mao YP,Liu LZ,et al. How does magnetic resonance imaging influence staging according to AJCC staging system for nasopharyngeal carcinoma compared with computed tomography?[J]. Int J Radiat Oncol Biol Phys,2008,72(5):1368-1377.DOI:10.1016/j.ijrobp.2008.03.017.