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Prognostic value of nasopharynx tumour volume in local-regional advanced nasopharyngeal carcinoma
BACKGROUND: To investigate the prognostic value of pretreatment primary gross tumor with (GTVp) and without retropharyngeal lymph nodes (GTVnx) for predicting survival outcomes in patients with local-regional advanced nasopharyngeal carcinoma (NPC) after intensity-modulated radiation therapy (IMRT)....
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154488/ https://www.ncbi.nlm.nih.gov/pubmed/32309370 http://dx.doi.org/10.21037/atm.2020.01.03 |
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author | Ni, Weiqiong Qi, Weixiang Xu, Fei Cao, Weiguo Xu, Cheng Chen, Jiayi Gao, Yunsheng |
author_facet | Ni, Weiqiong Qi, Weixiang Xu, Fei Cao, Weiguo Xu, Cheng Chen, Jiayi Gao, Yunsheng |
author_sort | Ni, Weiqiong |
collection | PubMed |
description | BACKGROUND: To investigate the prognostic value of pretreatment primary gross tumor with (GTVp) and without retropharyngeal lymph nodes (GTVnx) for predicting survival outcomes in patients with local-regional advanced nasopharyngeal carcinoma (NPC) after intensity-modulated radiation therapy (IMRT). METHODS: From Jan 2012 to Dec 2017, 148 patients with local-regional advanced NPC who had undergone definitive radiotherapy were identified. GTVnx volume and retropharyngeal lymph nodes (GTVrLNs) volume were measured based on registration of MRI with contrast-enhanced CT images. The Kaplan-Meier method was used for survival analysis. Univariate and multivariate prognostic analyses was performed by using the Cox proportional hazard model. Receiver operating characteristic (ROC) curves were used to identify the cut-off point and assess the prognostic value for GTVnx, GTVp and GTVrLNs. RESULTS: The median follow-up time for the entire group was 27 months (ranging 7 to 80 months). The 3-year overall survival (OS) rate was 85%, and the 3-year local failure-free rate (LFFR), distant failure-free rate (DFFR) and disease-free survival (DFS) rates were 93%, 81%, and 73%, respectively. A positive correlation between GTVnx or GTVp volume and T stage was observed (both P<0.001). The 3-year LFFR, OS, and DFS rate, but not for DMFS, in NPC patients with GTVnx ≤42.7 cm(3) was significantly better than those with >42.7 cm(3) (all P<0.05). Multivariate analysis indicated that GTVnx volume (P=0.041) was the only independent prognostic factor for LFFR, while age and AJCC stage were two independent prognostic factors for OS. CONCLUSIONS: The GTVnx is an independent prognostic factor for local control, while the prognostic value of GTVrLNs is limited. Physicians are recommended to distinguish between GTVnx and retropharyngeal lymph nodes (RLN) involvement when assessing the risk for local recurrence in advanced NPC. |
format | Online Article Text |
id | pubmed-7154488 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-71544882020-04-17 Prognostic value of nasopharynx tumour volume in local-regional advanced nasopharyngeal carcinoma Ni, Weiqiong Qi, Weixiang Xu, Fei Cao, Weiguo Xu, Cheng Chen, Jiayi Gao, Yunsheng Ann Transl Med Original Article BACKGROUND: To investigate the prognostic value of pretreatment primary gross tumor with (GTVp) and without retropharyngeal lymph nodes (GTVnx) for predicting survival outcomes in patients with local-regional advanced nasopharyngeal carcinoma (NPC) after intensity-modulated radiation therapy (IMRT). METHODS: From Jan 2012 to Dec 2017, 148 patients with local-regional advanced NPC who had undergone definitive radiotherapy were identified. GTVnx volume and retropharyngeal lymph nodes (GTVrLNs) volume were measured based on registration of MRI with contrast-enhanced CT images. The Kaplan-Meier method was used for survival analysis. Univariate and multivariate prognostic analyses was performed by using the Cox proportional hazard model. Receiver operating characteristic (ROC) curves were used to identify the cut-off point and assess the prognostic value for GTVnx, GTVp and GTVrLNs. RESULTS: The median follow-up time for the entire group was 27 months (ranging 7 to 80 months). The 3-year overall survival (OS) rate was 85%, and the 3-year local failure-free rate (LFFR), distant failure-free rate (DFFR) and disease-free survival (DFS) rates were 93%, 81%, and 73%, respectively. A positive correlation between GTVnx or GTVp volume and T stage was observed (both P<0.001). The 3-year LFFR, OS, and DFS rate, but not for DMFS, in NPC patients with GTVnx ≤42.7 cm(3) was significantly better than those with >42.7 cm(3) (all P<0.05). Multivariate analysis indicated that GTVnx volume (P=0.041) was the only independent prognostic factor for LFFR, while age and AJCC stage were two independent prognostic factors for OS. CONCLUSIONS: The GTVnx is an independent prognostic factor for local control, while the prognostic value of GTVrLNs is limited. Physicians are recommended to distinguish between GTVnx and retropharyngeal lymph nodes (RLN) involvement when assessing the risk for local recurrence in advanced NPC. AME Publishing Company 2020-03 /pmc/articles/PMC7154488/ /pubmed/32309370 http://dx.doi.org/10.21037/atm.2020.01.03 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Ni, Weiqiong Qi, Weixiang Xu, Fei Cao, Weiguo Xu, Cheng Chen, Jiayi Gao, Yunsheng Prognostic value of nasopharynx tumour volume in local-regional advanced nasopharyngeal carcinoma |
title | Prognostic value of nasopharynx tumour volume in local-regional advanced nasopharyngeal carcinoma |
title_full | Prognostic value of nasopharynx tumour volume in local-regional advanced nasopharyngeal carcinoma |
title_fullStr | Prognostic value of nasopharynx tumour volume in local-regional advanced nasopharyngeal carcinoma |
title_full_unstemmed | Prognostic value of nasopharynx tumour volume in local-regional advanced nasopharyngeal carcinoma |
title_short | Prognostic value of nasopharynx tumour volume in local-regional advanced nasopharyngeal carcinoma |
title_sort | prognostic value of nasopharynx tumour volume in local-regional advanced nasopharyngeal carcinoma |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154488/ https://www.ncbi.nlm.nih.gov/pubmed/32309370 http://dx.doi.org/10.21037/atm.2020.01.03 |
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