Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan 62247.
Radiat Oncol. 2010 Mar 11;5:20. doi: 10.1186/1748-717X-5-20.
Current staging systems have limited ability to adjust optimal therapy in advanced nasopharyngeal carcinoma (NPC). This study aimed to delineate the correlation between tumor volume, treatment outcome and chemotherapy cycles in advanced NPC.
A retrospective review of 110 patients with stage III-IV NPC was performed. All patients were treated first with neoadjuvant chemotherapy, then concurrent chemoradiation, and followed by adjuvant chemotherapy as being the definitive therapy. Gross tumor volume of primary tumor plus retropharyngeal nodes (GTVprn) was calculated to be an index of treatment outcome.
GTVprn had a close relationship with survival and recurrence in advanced NPC. Large GTVprn (> or =13 ml) was associated with a significantly poorer local control, lower distant metastasis-free rate, and poorer survival. In patients with GTVprn > or =13 ml, overall survival was better after > or =4 cycles of chemotherapy than after less than 4 cycles.
The incorporation of GTVprn can provide more information to adjust treatment strategy.
目前的分期系统在调整晚期鼻咽癌（NPC）的最佳治疗方案方面能力有限。本研究旨在探讨肿瘤体积与晚期 NPC 治疗结果和化疗周期之间的相关性。
对 110 例 III-IV 期 NPC 患者进行回顾性分析。所有患者均先接受新辅助化疗，然后进行同期放化疗，最后进行辅助化疗作为确定性治疗。原发肿瘤加咽后淋巴结的大体肿瘤体积（GTVprn）被计算为治疗结果的一个指标。
GTVprn 与晚期 NPC 的生存和复发密切相关。大的 GTVprn（≥13ml）与局部控制率显著降低、远处无转移率降低和生存率降低显著相关。在 GTVprn≥13ml 的患者中，接受≥4 个周期化疗的总生存率优于接受＜4 个周期化疗的患者。
GTVprn 的纳入可以提供更多信息来调整治疗策略。
