OBJECTIVES: The purpose of this study was to investigate factors associated with lymph node (LN) metastasis to identify which nasopharyngeal cancer (NPC) patients can undergo a reduction in the prophylactic radiation field. MRI of biopsy-proven NPC patients was evaluated to determine primary tumour extension and the existence of LN metastasis. METHODS: Sex, age, pathological type, T stage, primary tumour size, existence beyond the midline of the nasopharynx at the primary site and parapharyngeal extension of the primary tumour were assessed regarding their impact on the laterality of LN metastasis using the χ(2) test. RESULTS: Of the 167 patients, 149 (89%) showed nodal involvement. The existence beyond the midline of the nasopharynx was significantly associated with the laterality of LN metastasis (p<0.0001). Most patients (82%) with primary tumour presence within the midline showed only ipsilateral LN metastasis or no LN metastasis. In addition, contralateral LN metastases were seen only at Level II and the retropharyngeal LN among most of other patients. CONCLUSION: These results suggest that LN areas other than Level II and the retropharyngeal LN on the contralateral side could be omitted in patients with primary tumour presence within the midline and without the contralateral Level II or the retropharyngeal LN. Whether disease control is compromised by reducing the radiation field for subclinical diseases is a problem that should be solved in the future by prospective study.
OBJECTIVES: The purpose of this study was to investigate factors associated with lymph node (LN) metastasis to identify which nasopharyngeal cancer (NPC) patients can undergo a reduction in the prophylactic radiation field. MRI of biopsy-proven NPCpatients was evaluated to determine primary tumour extension and the existence of LN metastasis. METHODS: Sex, age, pathological type, T stage, primary tumour size, existence beyond the midline of the nasopharynx at the primary site and parapharyngeal extension of the primary tumour were assessed regarding their impact on the laterality of LN metastasis using the χ(2) test. RESULTS: Of the 167 patients, 149 (89%) showed nodal involvement. The existence beyond the midline of the nasopharynx was significantly associated with the laterality of LN metastasis (p<0.0001). Most patients (82%) with primary tumour presence within the midline showed only ipsilateral LN metastasis or no LN metastasis. In addition, contralateral LN metastases were seen only at Level II and the retropharyngeal LN among most of other patients. CONCLUSION: These results suggest that LN areas other than Level II and the retropharyngeal LN on the contralateral side could be omitted in patients with primary tumour presence within the midline and without the contralateral Level II or the retropharyngeal LN. Whether disease control is compromised by reducing the radiation field for subclinical diseases is a problem that should be solved in the future by prospective study.
Authors: Xiao Shen Wang; Chao Su Hu; Hong Mei Ying; Zheng Rong Zhou; Jian Hui Ding; Yan Feng Journal: Int J Radiat Oncol Biol Phys Date: 2008-06-04 Impact factor: 7.038
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Authors: Ivan Weng-Keong Tham; Siew Wan Hee; Richard Ming-Chert Yeo; Patemah Bte Salleh; James Lee; Terence Wee-Kiat Tan; Kam Weng Fong; Eu Tiong Chua; Joseph Tien-Seng Wee Journal: Int J Radiat Oncol Biol Phys Date: 2009-04-20 Impact factor: 7.038
Authors: Nam P Nguyen; Jacqueline Vock; Vincent Vinh-Hung; Fabio Almeida; Lars Ewell; Michael Betz; Siyoung Jang; Richard A Vo; Suresh Dutta; Juan Godinez; Ulf Karlsson; Alexander Chi Journal: BMC Cancer Date: 2012-06-18 Impact factor: 4.430
Authors: Wen-Fei Li; Ying Sun; Mo Chen; Ling-Long Tang; Li-Zhi Liu; Yan-Ping Mao; Lei Chen; Guan-Qun Zhou; Li Li; Jun Ma Journal: Chin J Cancer Date: 2012-08-02