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Hypertrophic adenoids in patients with nasopharyngeal carcinoma: appearance at magnetic resonance imaging before and after treatment
INTRODUCTION: Patients with nasopharyngeal carcinoma (NPC) sporadically develop abnormal adenoids. Nasopharyngeal adenoids are usually included in the gross tumor volume (GTV) but may have different therapeutic responses than tumor tissue. Therefore, distinguishing adenoids from tumor tissue may be...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593340/ https://www.ncbi.nlm.nih.gov/pubmed/25962737 http://dx.doi.org/10.1186/s40880-015-0005-y |
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author | Wu, Yao-Pan Cai, Pei-Qiang Tian, Li Xu, Jie-Hua Mitteer, Richard Alan Fan, Yi Zhang, Zhenfeng |
author_facet | Wu, Yao-Pan Cai, Pei-Qiang Tian, Li Xu, Jie-Hua Mitteer, Richard Alan Fan, Yi Zhang, Zhenfeng |
author_sort | Wu, Yao-Pan |
collection | PubMed |
description | INTRODUCTION: Patients with nasopharyngeal carcinoma (NPC) sporadically develop abnormal adenoids. Nasopharyngeal adenoids are usually included in the gross tumor volume (GTV) but may have different therapeutic responses than tumor tissue. Therefore, distinguishing adenoids from tumor tissue may be required for precise and efficient chemoradiotherapy and radiotherapy. We characterized nasopharyngeal adenoids and investigated the therapeutic responses of NPC and nasopharyngeal adenoids using magnetic resonance imaging (MRI). METHODS: MRI data from 40 NPC patients with a coexisting adenoid mass before and after treatment were analyzed. The features of the adenoid masses, including location, striped appearance, size, interface, symmetry/asymmetry, and cysts, were evaluated. Treatment response were scored according to the World Health Organization guidelines. RESULTS: A striped appearance was observed in 36 cases before treatment and in all cases after treatment. In these 36 cases, the average GTVs including and excluding the uninvolved adenoids were 19.8 cm(3) and 14.8 cm(3), respectively. The average percentage change after excluding the uninvolved adenoids from the GTV was 31.0%. Stable disease in the adenoids was identified in 27 (96.4%) of 28 patients after neoadjuvant chemotherapy, while NPC clearly regressed. Partial adenoid responses were identified in 33 (82.5%) of 40 patients at 3 months after chemoradiotherapy or radiotherapy, whereas complete tumor responses were achieved in all patients. Six months after treatment, the adenoids continued to atrophy but did not disappear, and tumor recurrence was not found. CONCLUSIONS: Nasopharyngeal adenoids and carcinoma tissue in NPC patients can be distinguished by using MRI and have different responses to chemoradiotherapy and radiotherapy. These findings contribute to better delineating the GTV of NPC, based on which spatially optimized strategies can be developed to render precise and efficient chemoradiotherapy and radiotherapy. Additionally, we observed a clear difference in the responses of these two tissue types to current therapies. This finding may reduce or avoid unnecessary biopsies or overtreatment. |
format | Online Article Text |
id | pubmed-4593340 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-45933402015-10-06 Hypertrophic adenoids in patients with nasopharyngeal carcinoma: appearance at magnetic resonance imaging before and after treatment Wu, Yao-Pan Cai, Pei-Qiang Tian, Li Xu, Jie-Hua Mitteer, Richard Alan Fan, Yi Zhang, Zhenfeng Chin J Cancer Original Article INTRODUCTION: Patients with nasopharyngeal carcinoma (NPC) sporadically develop abnormal adenoids. Nasopharyngeal adenoids are usually included in the gross tumor volume (GTV) but may have different therapeutic responses than tumor tissue. Therefore, distinguishing adenoids from tumor tissue may be required for precise and efficient chemoradiotherapy and radiotherapy. We characterized nasopharyngeal adenoids and investigated the therapeutic responses of NPC and nasopharyngeal adenoids using magnetic resonance imaging (MRI). METHODS: MRI data from 40 NPC patients with a coexisting adenoid mass before and after treatment were analyzed. The features of the adenoid masses, including location, striped appearance, size, interface, symmetry/asymmetry, and cysts, were evaluated. Treatment response were scored according to the World Health Organization guidelines. RESULTS: A striped appearance was observed in 36 cases before treatment and in all cases after treatment. In these 36 cases, the average GTVs including and excluding the uninvolved adenoids were 19.8 cm(3) and 14.8 cm(3), respectively. The average percentage change after excluding the uninvolved adenoids from the GTV was 31.0%. Stable disease in the adenoids was identified in 27 (96.4%) of 28 patients after neoadjuvant chemotherapy, while NPC clearly regressed. Partial adenoid responses were identified in 33 (82.5%) of 40 patients at 3 months after chemoradiotherapy or radiotherapy, whereas complete tumor responses were achieved in all patients. Six months after treatment, the adenoids continued to atrophy but did not disappear, and tumor recurrence was not found. CONCLUSIONS: Nasopharyngeal adenoids and carcinoma tissue in NPC patients can be distinguished by using MRI and have different responses to chemoradiotherapy and radiotherapy. These findings contribute to better delineating the GTV of NPC, based on which spatially optimized strategies can be developed to render precise and efficient chemoradiotherapy and radiotherapy. Additionally, we observed a clear difference in the responses of these two tissue types to current therapies. This finding may reduce or avoid unnecessary biopsies or overtreatment. BioMed Central 2015-03-05 /pmc/articles/PMC4593340/ /pubmed/25962737 http://dx.doi.org/10.1186/s40880-015-0005-y Text en © Wu et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Article Wu, Yao-Pan Cai, Pei-Qiang Tian, Li Xu, Jie-Hua Mitteer, Richard Alan Fan, Yi Zhang, Zhenfeng Hypertrophic adenoids in patients with nasopharyngeal carcinoma: appearance at magnetic resonance imaging before and after treatment |
title | Hypertrophic adenoids in patients with nasopharyngeal carcinoma: appearance at magnetic resonance imaging before and after treatment |
title_full | Hypertrophic adenoids in patients with nasopharyngeal carcinoma: appearance at magnetic resonance imaging before and after treatment |
title_fullStr | Hypertrophic adenoids in patients with nasopharyngeal carcinoma: appearance at magnetic resonance imaging before and after treatment |
title_full_unstemmed | Hypertrophic adenoids in patients with nasopharyngeal carcinoma: appearance at magnetic resonance imaging before and after treatment |
title_short | Hypertrophic adenoids in patients with nasopharyngeal carcinoma: appearance at magnetic resonance imaging before and after treatment |
title_sort | hypertrophic adenoids in patients with nasopharyngeal carcinoma: appearance at magnetic resonance imaging before and after treatment |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593340/ https://www.ncbi.nlm.nih.gov/pubmed/25962737 http://dx.doi.org/10.1186/s40880-015-0005-y |
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