Min Kang1, Pingting Zhou1, Tingting Wei1, Tingting Zhao1, Jianxiong Long2, Guisheng Li3, Haolin Yan4, Guosheng Feng5, Meilian Liu6, Jinxian Zhu7, Rensheng Wang1. 1. Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University Nanning 530021, Guangxi, P. R. China. 2. School of Public Health, Guangxi Medical University Nanning 530021, Guangxi, P. R. China. 3. Department of Radiation Oncology, Liuzhou Worker Hospital Liuzhou 545000, Guangxi, P. R. China. 4. Department of Radiation Oncology, First People's Hospital of Yulin City Yulin 537000, Guangxi, P. R. China. 5. Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region Nanning 530021, Guangxi, P. R. China. 6. Department of Radiation Oncology, Affiliated Hospital of Guilin Medical University Guilin 541000, Guangxi, P. R. China. 7. Department of Radiation Oncology, Wuzhou Red Cross Hospital Wuzhou 543000, Guangxi, P. R. China.
Abstract
PURPOSE: This prospective multicentric study aimed to establish a new clinical T staging standard for nasopharyngeal carcinoma (NPC) based on intensity-modulated radiotherapy (IMRT). METHODS AND MATERIALS: Between January 2006 and December 2009, four hundred and ninety-two NPC patients undergoing IMRT were staged according to the seventh edition of the UICC/AJCC staging system. The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used to compare survival differences. RESULTS: The 5-year overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and distant metastasis-free survival (DMSF) rates were 80.5%, 78.6%, 94.1%, and 84.3%, respectively. Univariate and multivariate analyses showed that the invasion of the nasal cavity, parapharyngeal space, oropharynx, skull base, internal pterygoid muscle, external pterygoid muscle, paranasal sinus, infratemporal fossa, orbit, cranial nerves, cavernous sinus, and intracalvarium were independent prognostic factors (P<0.05). According to the results of risk variety and survival curves, we suggest that the new T staging system for NPC based on magnetic resonance imaging and intensity modulated radiation therapy can be classified as T1 (nasopharynx, nasal cavity, parapharyngeal space, oropharynx, skull base and internal pterygoid muscle) and T2 (external pterygoid muscle, paranasal sinus, infratemporal fossa, orbit, cranial nerves, cavernous sinus and intracalvarium). Compared to the seventh edition of UICC/AJCC staging system, our new recommended staging system performs better in risk difference and distribution balance. Furthermore, the differences between the substages of 5-year curves of LRFS, DMFS and OS were all statistically significant in our new recommended staging system. CONCLUSIONS: Our new recommended staging system is more adaptable to IMRT and can predict the prognosis of NPC patient in a more objective and accurate manner.
PURPOSE: This prospective multicentric study aimed to establish a new clinical T staging standard for nasopharyngeal carcinoma (NPC) based on intensity-modulated radiotherapy (IMRT). METHODS AND MATERIALS: Between January 2006 and December 2009, four hundred and ninety-two NPCpatients undergoing IMRT were staged according to the seventh edition of the UICC/AJCC staging system. The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used to compare survival differences. RESULTS: The 5-year overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and distant metastasis-free survival (DMSF) rates were 80.5%, 78.6%, 94.1%, and 84.3%, respectively. Univariate and multivariate analyses showed that the invasion of the nasal cavity, parapharyngeal space, oropharynx, skull base, internal pterygoid muscle, external pterygoid muscle, paranasal sinus, infratemporal fossa, orbit, cranial nerves, cavernous sinus, and intracalvarium were independent prognostic factors (P<0.05). According to the results of risk variety and survival curves, we suggest that the new T staging system for NPC based on magnetic resonance imaging and intensity modulated radiation therapy can be classified as T1 (nasopharynx, nasal cavity, parapharyngeal space, oropharynx, skull base and internal pterygoid muscle) and T2 (external pterygoid muscle, paranasal sinus, infratemporal fossa, orbit, cranial nerves, cavernous sinus and intracalvarium). Compared to the seventh edition of UICC/AJCC staging system, our new recommended staging system performs better in risk difference and distribution balance. Furthermore, the differences between the substages of 5-year curves of LRFS, DMFS and OS were all statistically significant in our new recommended staging system. CONCLUSIONS: Our new recommended staging system is more adaptable to IMRT and can predict the prognosis of NPCpatient in a more objective and accurate manner.
Entities:
Keywords:
Nasopharyngeal carcinoma; T staging; intensity modulated radiation therapy; magnetic resonance imaging; prognosis
Authors: A W Lee; W Foo; S C Law; Y F Poon; S K O; S Y Tung; W M Sze; R Chappell; W H Lau; J H Ho Journal: Int J Cancer Date: 1999-04-20 Impact factor: 7.396
Authors: D M Heng; J Wee; K W Fong; L G Lian; V K Sethi; E T Chua; T L Yang; H S Khoo Tan; K S Lee; K M Lee; T Tan; E J Chua Journal: Cancer Date: 1999-11-15 Impact factor: 6.860
Authors: Anne W M Lee; W H Lau; Stewart Y Tung; Daniel T T Chua; Rick Chappell; L Xu; Lillian Siu; W M Sze; T W Leung; Jonathan S T Sham; Roger K C Ngan; Stephen C K Law; T K Yau; Joseph S K Au; Brian O'Sullivan; Ellie S Y Pang; S K O; Gordon K H Au; Joseph T Lau Journal: J Clin Oncol Date: 2005-10-01 Impact factor: 44.544
Authors: Anne W M Lee; W M Sze; Joseph S K Au; S F Leung; T W Leung; Daniel T T Chua; Benny C Y Zee; Stephen C K Law; Peter M L Teo; Stewart Y Tung; Dora L W Kwong; W H Lau Journal: Int J Radiat Oncol Biol Phys Date: 2005-03-15 Impact factor: 7.038
Authors: T Miura; N Hirabuki; K Nishiyama; T Hashimoto; R Kawai; J Yoshida; R Sasaki; T Matsunaga; T Kozuka Journal: Cancer Date: 1990-01-01 Impact factor: 6.860