Paranasal Sinus Invasion in Nasopharyngeal Carcinoma after Intensity-Modulated Radiotherapy
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Purpose The aim of this study is to evaluate the prognostic significance of paranasal sinus invasion for nasopharyngeal carcinoma (NPC) and its suitable position in the T classification. Materials and Methods The magnetic resonance imaging (MRI) scans of 695 patients with previously untreated, biopsy-proven, non-metastatic NPC that was treated with intensity-modulated radiotherapy (IMRT) were reviewed retrospectively. Results The incidence of paranasal sinus invasion was 39.4% (274 of 695 patients). Multivariate analysis showed that paranasal sinus invasion was an independent negative prognostic factor for local failure-free survival (LFFS) (p < 0.05). According to the eighth American Joint Committee on Cancer (AJCC) staging system, 275 patients were classified as T3 classification. Of these, 78 patients (28.4%) developed paranasal sinus invasion (T3b) and 197 (71.6%) didn’t (T3a). The estimated 5-year LFFS and overall survival (OS) rates for the patients with T3b and T3a classification were 88.6% versus 95.0% (p=0.047), and 84.5% versus 93.3% (p=0.183), respectively. The estimated 5-year LFFS and OS rates for the patients with T4 classification were 89.5% and 83.2%, which were similar with the outcomes of patients with T3b classification. Conclusion MRI-determined paranasal sinus invasion is an independent prognostic factor of NPC treated by IMRT. Paranasal sinus invasion is recommended to classify as T4 classification in the 8th AJCC staging system for NPC.
Abstract
Purpose The aim of this study is to evaluate the prognostic significance of paranasal sinus invasion for nasopharyngeal carcinoma (NPC) and its suitable position in the T classification. Materials and Methods The magnetic resonance imaging (MRI) scans of 695 patients with previously untreated, biopsy-proven, non-metastatic NPC that was treated with intensity-modulated radiotherapy (IMRT) were reviewed retrospectively. Results The incidence of paranasal sinus invasion was 39.4% (274 of 695 patients). Multivariate analysis showed that paranasal sinus invasion was an independent negative prognostic factor for local failure-free survival (LFFS) (p < 0.05). According to the eighth American Joint Committee on Cancer (AJCC) staging system, 275 patients were classified as T3 classification. Of these, 78 patients (28.4%) developed paranasal sinus invasion (T3b) and 197 (71.6%) didn’t (T3a). The estimated 5-year LFFS and overall survival (OS) rates for the patients with T3b and T3a classification were 88.6% versus 95.0% (p=0.047), and 84.5% versus 93.3% (p=0.183), respectively. The estimated 5-year LFFS and OS rates for the patients with T4 classification were 89.5% and 83.2%, which were similar with the outcomes of patients with T3b classification. Conclusion MRI-determined paranasal sinus invasion is an independent prognostic factor of NPC treated by IMRT. Paranasal sinus invasion is recommended to classify as T4 classification in the 8th AJCC staging system for NPC.
참고문헌 (20)
- International Agency for Research on Cancer, "GLOBOCAN 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012" (2012), IARC Press
- Amin MB, "AJCC cancer staging manual" (2017), Springer
- Pan JJ, "Proposal for the 8th edition of the AJCC", UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy, 2016, pp.122, 546~558
- Chinese Committee for Staging of Nasopharyngeal Carcinoma, "Report on revision of the Chinese 1992 staging system for nasopharyngeal carcinoma", J Radiat Oncol, 2, pp.233~240 (2013)
- Caineng Cao, "Magnetic Resonance Imaging–Detected Intracranial Extension in the T4 Classification Nasopharyngeal Carcinoma with Intensity-Modulated Radiotherapy", Cancer Research and Treatment, 49(2), pp.518~525 (2017), 대한암학회
- Chong VF, "Computed tomographic and magnetic resonance imaging findings in paranasal sinus involvement in nasopharyngeal carcinoma", Ann Acad Med Singapore, 27, pp.800~804 (1998)
- King AD, "MRI of local disease in nasopharyngeal carcinoma : tumour extent vs tumour stage", Br J Radiol, 72, pp.734~741 (1999)
- Tao CJ, "Prognostic scoring system for locoregional control among the patients with nasopharyngeal carcinoma treated by intensitymodulated radiotherapy", Chin J Cancer, 32, pp.494~501 (2013)
- Tian L, "Nasopharyngeal carcinoma with paranasal sinus invasion : the prognostic significance and the evidence-based study basis of its T-staging category according to the AJCC staging system", BMC Cancer, 14, pp.832~ (2014)
- Zhang Y, "Should all nasopharyngeal carcinoma with paranasal sinus invasion be staged as T3 in the intensity-modulated radiotherapy era? A study of 1811 cases", J Cancer, 7, pp.1353~1359 (2016)
- Jin T, "Neoadjuvant chemotherapy with different dose regimens of docetaxel, cisplatin and fluorouracil(TPF)for locoregionally advanced nasopharyngeal carcinoma : a retrospective study", Oncotarget, 8, pp.100764~100772 (2017)
- Chung NN, "Impact of magnetic resonance imaging versus CT on nasopharyngeal carcinoma : primary tumor target delineation for radiotherapy", Head Neck, 26, pp.241~246 (2004)
- Abdel Khalek Abdel Razek A, "MRI and CT of nasopharyngeal carcinoma", AJR Am J Roentgenol, 198, pp.11~18 (2012)
- Lee AW, "Treatment results for nasopharyngeal carcinoma in the modern era : the Hong Kong experience", Int J Radiat Oncol Biol Phys, 61, pp.1107~1116 (2005)
- Chua ML, "Nasopharyngeal carcinoma", Lancet, 387, pp.1012~1024 (2016)
- Sun X, "Long-term outcomes of intensity-modulated radiotherapy for 868patients with nasopharyngeal carcinoma : an analysis of survival and treatment toxicities", Radiother Oncol, 110, pp.398~403 (2014)
- Chen L, "Grading of MRI-detected skull-base invasion in nasopharyngeal carcinoma and its prognostic value", Head Neck, 33, pp.1309~1314 (2011)
- Cao CN, "Update report of T4 classification nasopharyngeal carcinoma after intensity-modulated radiotherapy : an analysis of survival and treatment toxicities", Oral Oncol, 51, pp.190~194 (2015)
- Lee AW, "Management of nasopharyngeal carcinoma : current practice and future perspective", J Clin Oncol, 33, pp.3356~3364 (2015)
- Shedd DP, "Cancer of the nasopharynx in Connecticut, 1935 through 1959", Cancer, 20, pp.508~511 (1967)