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Locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation

Clinical target volume (CTV) delineation is crucial for tumor control and normal tissue protection. This study aimed to define the locoregional extension patterns of nasopharyngeal carcinoma (NPC) and to improve CTV delineation. Magnetic resonance imaging scans of 2366 newly diagnosed NPC patients w...

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Autores principales: Li, Wen-Fei, Sun, Ying, Chen, Mo, Tang, Ling-Long, Liu, Li-Zhi, Mao, Yan-Ping, Chen, Lei, Zhou, Guan-Qun, Li, Li, Ma, Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sun Yat-sen University Cancer Center 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777458/
https://www.ncbi.nlm.nih.gov/pubmed/22854064
http://dx.doi.org/10.5732/cjc.012.10095
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author Li, Wen-Fei
Sun, Ying
Chen, Mo
Tang, Ling-Long
Liu, Li-Zhi
Mao, Yan-Ping
Chen, Lei
Zhou, Guan-Qun
Li, Li
Ma, Jun
author_facet Li, Wen-Fei
Sun, Ying
Chen, Mo
Tang, Ling-Long
Liu, Li-Zhi
Mao, Yan-Ping
Chen, Lei
Zhou, Guan-Qun
Li, Li
Ma, Jun
author_sort Li, Wen-Fei
collection PubMed
description Clinical target volume (CTV) delineation is crucial for tumor control and normal tissue protection. This study aimed to define the locoregional extension patterns of nasopharyngeal carcinoma (NPC) and to improve CTV delineation. Magnetic resonance imaging scans of 2366 newly diagnosed NPC patients were reviewed. According to incidence rates of tumor invasion, the anatomic sites surrounding the nasopharynx were classified into high-risk (>30%), medium-risk (5%–30%), and low-risk (<5%) groups. The lymph node (LN) level was determined according to the Radiation Therapy Oncology Group guidelines, which were further categorized into the upper neck (retropharyngeal region and level II), middle neck (levels III and Va), and lower neck (levels IV and Vb and the supraclavicular fossa). The high-risk anatomic sites were adjacent to the nasopharynx, whereas those at medium- or low-risk were separated from the nasopharynx. If the high-risk anatomic sites were involved, the rates of tumor invasion into the adjacent medium-risk sites increased; if not, the rates were significantly lower (P < 0.01). Among the 1920 (81.1%) patients with positive LN, the incidence rates of LN metastasis in the upper, middle, and lower neck were 99.6%, 30.2%, and 7.2%, respectively, and skip metastasis happened in only 1.2% of patients. In the 929 patients who had unilateral upper neck involvement, the rates of contralateral middle neck and lower neck involvement were 1.8% and 0.4%, respectively. Thus, local disease spreads stepwise from proximal sites to distal sites, and LN metastasis spreads from the upper neck to the lower neck. Individualized CTV delineation for NPC may be feasible.
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spelling pubmed-37774582013-12-11 Locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation Li, Wen-Fei Sun, Ying Chen, Mo Tang, Ling-Long Liu, Li-Zhi Mao, Yan-Ping Chen, Lei Zhou, Guan-Qun Li, Li Ma, Jun Chin J Cancer Original Article Clinical target volume (CTV) delineation is crucial for tumor control and normal tissue protection. This study aimed to define the locoregional extension patterns of nasopharyngeal carcinoma (NPC) and to improve CTV delineation. Magnetic resonance imaging scans of 2366 newly diagnosed NPC patients were reviewed. According to incidence rates of tumor invasion, the anatomic sites surrounding the nasopharynx were classified into high-risk (>30%), medium-risk (5%–30%), and low-risk (<5%) groups. The lymph node (LN) level was determined according to the Radiation Therapy Oncology Group guidelines, which were further categorized into the upper neck (retropharyngeal region and level II), middle neck (levels III and Va), and lower neck (levels IV and Vb and the supraclavicular fossa). The high-risk anatomic sites were adjacent to the nasopharynx, whereas those at medium- or low-risk were separated from the nasopharynx. If the high-risk anatomic sites were involved, the rates of tumor invasion into the adjacent medium-risk sites increased; if not, the rates were significantly lower (P < 0.01). Among the 1920 (81.1%) patients with positive LN, the incidence rates of LN metastasis in the upper, middle, and lower neck were 99.6%, 30.2%, and 7.2%, respectively, and skip metastasis happened in only 1.2% of patients. In the 929 patients who had unilateral upper neck involvement, the rates of contralateral middle neck and lower neck involvement were 1.8% and 0.4%, respectively. Thus, local disease spreads stepwise from proximal sites to distal sites, and LN metastasis spreads from the upper neck to the lower neck. Individualized CTV delineation for NPC may be feasible. Sun Yat-sen University Cancer Center 2012-12 /pmc/articles/PMC3777458/ /pubmed/22854064 http://dx.doi.org/10.5732/cjc.012.10095 Text en Chinese Journal of Cancer http://creativecommons.org/licenses/by-nc-sa/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License, which allows readers to alter, transform, or build upon the article and then distribute the resulting work under the same or similar license to this one. The work must be attributed back to the original author and commercial use is not permitted without specific permission.
spellingShingle Original Article
Li, Wen-Fei
Sun, Ying
Chen, Mo
Tang, Ling-Long
Liu, Li-Zhi
Mao, Yan-Ping
Chen, Lei
Zhou, Guan-Qun
Li, Li
Ma, Jun
Locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation
title Locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation
title_full Locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation
title_fullStr Locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation
title_full_unstemmed Locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation
title_short Locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation
title_sort locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777458/
https://www.ncbi.nlm.nih.gov/pubmed/22854064
http://dx.doi.org/10.5732/cjc.012.10095
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