Abstract

BackgroundThe aim of this study is to evaluate the prognostic value of grading MRI–detected skull-base invasion in nasopharyngeal carcinoma (NPC) with skull-base invasion after intensity-modulated radiotherapy (IMRT).MethodsThis study is a retrospective chart review of 469 non-metastatic NPC patients with skull-base invasion. Patients were classified as extensive skull-base invasion (ESBI) group and limited skull-base invasion (LSBI) group.ResultsMultivariate analysis showed that the skull-base invasion (LSBI vs. ESBI) was an independent prognostic predictor of progression free survival (PFS). The estimated 5-year local failure free survival (LFFS), distant metastasis free survival (DMFS), PFS, and overall survival (OS) rates for patients in the T3-LSBI and T3-ESBI group were 92.9% versus 93.5, 89.8% versus 86.1, 81.6% versus 76.4, and 93.5% versus 86.3%, respectively (P > 0.05).ConclusionGrading of MRI-detected skull-base invasion is an independent prognostic factor of NPC with skull-base invasion. It is scientific and reasonable for skull-base invasion as a single entity to be classified as T3 classification.

Highlights

  • Nasopharyngeal carcinoma (NPC) is endemic in China and over 33,000 new patients were diagnosed in 2012 [1]

  • According to the 8th edition of the American Joint Committee on Cancer (AJCC) staging system for nasopharyngeal carcinoma (NPC), T classification is based on the anatomical extent of the primary tumor and which has been proposed in the era of intensity-modulated radiotherapy (IMRT) [2, 3]

  • Of the 469 patients, 185 patients were classified into the limited skull-base invasion (LSBI) group, and 284 patients were classified into the extensive skull-base invasion (ESBI) group

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Summary

Introduction

Nasopharyngeal carcinoma (NPC) is endemic in China and over 33,000 new patients were diagnosed in 2012 [1]. According to the 8th edition of the American Joint Committee on Cancer (AJCC) staging system for NPC, T classification is based on the anatomical extent of the primary tumor and which has been proposed in the era of intensity-modulated radiotherapy (IMRT) [2, 3]. With respect to the prognostic value of magnetic resonance imaging (MRI)-detected skull-base invasion for NPC, there are limited reports, especially, for patients treated by IMRT [4,5,6]. The aim of this study is to grade MRI–detected skull-base invasion in NPC with. The aim of this study is to evaluate the prognostic value of grading MRI–detected skull-base invasion in nasopharyngeal carcinoma (NPC) with skull-base invasion after intensity-modulated radiotherapy (IMRT)

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