Abstract Objective To evaluate the prognostic impact of MRI-detected prevertebral space involvement in nasopharyngeal carcinoma (NPC) treated with radiotherapy and chemotherapy. Methods A retrospective analysis was performed on the clinical data of 333 patients who had newly diagnosed biopsy-proven NPC without distant metastasis from 2005 to 2007. All patients underwent MRI scans of the nasopharynx and neck and were treated with two-and three-dimensional radiotherapy without or without chemotherapy. The Kaplan-Meier method was used to calculate overall survival (OS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS), and the log-rank test was used for survival difference analysis;the Cox proportional hazards regression analysis was used to assess the prognostic value of prevertebral space involvement. Results The follow-up rate was 95.2%. Prevertebral space involvement was seen in 139(41.7%) of these patients. The patients with prevertebral space involvement had significantly higher T stage and clinical stage than those without prevertebral space involvement (χ2=90.41, P=0.000;χ2=54.03,P=0.000). The 5-year OS, DMFS, and LRFS for NPC patients with and without prevertebral space involvement were 58.8% vs. 77.5%(χ2=11.95, P=0.000), 77.8% vs. 85.0%(χ2=2.56, P=0.110), and 88.3% vs. 91.8%(χ2=1.51, P=0.220), respectively. After adjusting for N stage, a significant difference was still seen between the two groups with regard to 5-year OS (χ2=9.93, P=0.002). The multivariate analysis showed that prevertebral space involvement was not the independent prognostic factor for OS, DMFS, and LRFS (χ2=0.43, P=0.512;χ2=0.08, P=0.783;χ2=0.00, P=0.971). Conclusions The frequency of prevertebral space involvement is very high in NPC. The OS for the patients with prevertebral space involvement is significantly lower than those without prevertebral space involvement. But prevertebral space involvement is not the independent prognostic factor in NPC patients.
LI Shao-en,LIANG Shao-bo,ZHANG Ning et al. Prognostic impact of MRI-detected prevertebral space involvement in nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2013, 22(4): 295-298.
LI Shao-en,LIANG Shao-bo,ZHANG Ning et al. Prognostic impact of MRI-detected prevertebral space involvement in nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2013, 22(4): 295-298.
[1] Edge SB, Byrd DR, Compton CC, et al. AJCC Cancer Staging Manual. 7th ed. Philadelphia:Lippincott-Raven,2009. [2] Ng SH, Chang TC, Ko SF, et al. Nasopharyngeal carcinoma:MRI and CT assessment. Neuroradiology,1997,39:741-746. [3] 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? Int J Radiat Oncol Biol Phys,2008,72:1368-1377. [4] Liang SB, Sun Y, Liu LZ, et al. Extension of local disease in nasopharyngeal carcinoma detected by magnetic resonance imaging:improvement of clinical target volume delineation. Int J Radiat Oncol Biol Phys,2009,75:742-750. [5] Hsu WC, Loevner LA, Karpati R, et al. Accuracy of magnetic resonance imaging in predicting absence of fixation of head and neck cancer to the prevertebral space. Head Neck,2005,27:95-100. [6] Loevner LA, Ott IL, Yousem DM, et al. Neoplastic fixation to the prevertebral compartment by squamous cell carcinoma of the head and neck. Am J Roentgenol,1998,170:1389-1394. [7] 谢传淼,梁碧玲,林浩皋,等.MRI对鼻咽癌T、N分期的影响.中华肿瘤杂志,2002,24:181-184. [8] 唐曦,胡国清. CT和MRI在鼻咽癌临床分期中的价值. 国外医学(肿瘤学分册),2004,31:609-611. [9] Lee CC, Chu ST, Chou P, et al. The prognostic influence of prevertebral space involvement in nasopharyngeal carcinoma. Clin Otolaryngol,2008,33:442-449. [10] Zhou GQ, Mao YP, Chen L, et al. Prognostic value of prevertebral space involvement in nasopharyngeal carcinoma based on intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys,2012,82:1090-1097. [11] Lai SZ, Li WF, Chen L, et al. How does intensity-modulated radiotherapy versus conventional two-dimensional radiotherapy influence the treatment results in nasopharyngeal carcinoma patients? Int J Radiat Oncol Biol Phys,2011,80:661-668. [12] 易俊林,高黎,徐国镇,等.147例鼻咽癌调强放疗结果分析.中华放射肿瘤学杂志,2008,17:329-334. [13] 马礼钦,张瑜,潘建基,等.鼻咽癌患者调强放疗后的生存质量分析. 中华放射肿瘤学杂志,2009,18:425-429.