PURPOSE: To investigate the prognostic significance of prevertebral space involvement (PSI) in patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). METHODS AND MATERIALS: A retrospective review of data from 506 biopsy-proven, nonmetastatic NPCs was performed. Patients underwent magnetic resonance imaging examinations and received IMRT as their primary treatment. RESULTS: In this series, 161 NPC patients (31.8%) had PSI. Parapharyngeal space (p < 0.001), skull base (p < 0.001), and paranasal sinuses (p = 0.009) were associated with PSI after multivariate analysis. The 4-year overall survival (OS), local relapse-free survival (LRFS), distant metastasis-free survival (DMFS) for NPC patients with and without PSI was 69.1% and 89.2% (p < 0.0001), 83.9% and 96.4% (p < 0.0001), and 71.6% and 89.6% (p < 0.0001), respectively. Multivariate analysis identified PSI as an independent negative prognostic factor for both OS (HR = 1.478-4.380; p = 0.001) and DMFS (HR = 1.389-4.174; p = 0.002). Patients with PSI had similar survival rates in OS and DMFS (p = 0.241 and p = 0.493, respectively) to that of T4 disease, while the differences between PSI and T3 disease in both OS and DMFS were distinctly significant (p = 0.029 and p = 0.029, respectively). CONCLUSIONS: For NPC patients treated with IMRT, PSI was found to be an independent prognostic factor for both OS and DMFS. It seems reasonable that PSI should be classified as a T4 disease on the basis of the current American Joint Committee on Cancer staging classification criteria.
PURPOSE: To investigate the prognostic significance of prevertebral space involvement (PSI) in patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). METHODS AND MATERIALS: A retrospective review of data from 506 biopsy-proven, nonmetastatic NPCs was performed. Patients underwent magnetic resonance imaging examinations and received IMRT as their primary treatment. RESULTS: In this series, 161 NPCpatients (31.8%) had PSI. Parapharyngeal space (p < 0.001), skull base (p < 0.001), and paranasal sinuses (p = 0.009) were associated with PSI after multivariate analysis. The 4-year overall survival (OS), local relapse-free survival (LRFS), distant metastasis-free survival (DMFS) for NPCpatients with and without PSI was 69.1% and 89.2% (p < 0.0001), 83.9% and 96.4% (p < 0.0001), and 71.6% and 89.6% (p < 0.0001), respectively. Multivariate analysis identified PSI as an independent negative prognostic factor for both OS (HR = 1.478-4.380; p = 0.001) and DMFS (HR = 1.389-4.174; p = 0.002). Patients with PSI had similar survival rates in OS and DMFS (p = 0.241 and p = 0.493, respectively) to that of T4 disease, while the differences between PSI and T3 disease in both OS and DMFS were distinctly significant (p = 0.029 and p = 0.029, respectively). CONCLUSIONS: For NPCpatients treated with IMRT, PSI was found to be an independent prognostic factor for both OS and DMFS. It seems reasonable that PSI should be classified as a T4 disease on the basis of the current American Joint Committee on Cancer staging classification criteria.
Authors: Qi-Yong Ai; Chen-Wen Hu; Kunwar S Bhatia; Darren M C Poon; Edwin P Hui; Frankie K F Mo; Benjamin King Hong Law; Macy Tong; Brigette B Ma; Anthony T C Chan; Ann D King Journal: Eur Arch Otorhinolaryngol Date: 2017-11-29 Impact factor: 2.503
Authors: Jian Ji Pan; Wai Tong Ng; Jing Feng Zong; Lucy L K Chan; Brian O'Sullivan; Shao Jun Lin; Henry C K Sze; Yun Bin Chen; Horace C W Choi; Qiao Juan Guo; Wai Kuen Kan; You Ping Xiao; Xu Wei; Quynh Thu Le; Christine M Glastonbury; A Dimitrios Colevas; Randal S Weber; Jatin P Shah; Anne W M Lee Journal: Cancer Date: 2015-11-20 Impact factor: 6.860
Authors: X Liu; L-Z Liu; Y-P Mao; L Chen; L-L Tang; G-Q Zhou; Y Sun; D Yue; A-H Lin; L Li; J Ma Journal: Br J Cancer Date: 2014-02-04 Impact factor: 7.640