期刊
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
卷 84, 期 1, 页码 196-202出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ijrobp.2011.11.021
关键词
Nasopharyngeal carcinoma; Subclassification; T4 classification; Prognostic value; The seventh edition of American Joint Committee on Cancer staging system
资金
- Science Foundation of Key Hospital Clinical Program of Ministry of Health P.R. China [2010-178]
- Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme
- International Cooperation Foundation of Guangdong Science and Technology Department of China [2008B050100039]
Purpose: To subclassify patients with the T4 classification nasopharyngeal carcinoma (NPC), according to the seventh edition of the American Joint Committee on Cancer staging system, using magnetic resonance imaging (MRI), and to evaluate the prognostic value of subclassification after intensity-modulated radiotherapy (IMRT). Methods and Materials: A total of 140 patients who underwent MRI and were subsequently histologically diagnosed with nondisseminated classification T4 NPC received IMRT as their primary treatment and were included in this retrospective study. T4 patients were subclassified into two grades: T4a was defined as a primary nasopharyngeal tumor with involvement of the masticator space only; and T4b was defined as involvement of the intracranial region, cranial nerves, and/or orbit. Results: The 5-year overall survival (OS) rate and distant metastasis-free survival (DMFS) rate for T4a patients (82.5% and 87.0%, respectively), were significantly higher than for T4b patients (62.6% and 66.8%; p = 0.033 and p = 0.036, respectively). The T4a/b subclassification was an independent prognostic factor for OS (hazard ratio = 2.331, p = 0.032) and DMFS (hazard ratio = 2.602, p = 0.034), and had no significant effect on local relapse-free survival. Conclusions: Subclassification of T4 patients, as T4a or T4b, using MRI according to the site of invasion, has prognostic value for the outcomes of IMRT treatment in NPC. (C) 2012 Elsevier Inc.
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