Department of Otolaryngology, Buddhist Tzu Chi Dalin General Hospital, Chiayi County 622, Taiwan.
Radiat Oncol. 2010 Aug 16;5:72. doi: 10.1186/1748-717X-5-72.
Our previous study showed a close relationship between computed tomography (CT)-derived bidimensional measurement of primary tumor and retropharyngeal nodes (BDMprn) and gross tumor volume of primary tumor and retropharyngeal nodes (GTVprn) in nasopharyngeal carcinoma (NPC) and better prognosis for NPC patients with smaller BDMprn. In this study, we report the results on of a study to validate the use of BDM in a separate cohort of NPC patients.
We retrospectively reviewed 103 newly diagnosed NPC cases who were treated with radiotherapy/concurrent chemoradiotherapy (CCRT) or CCRT with adjuvant chemotherapy from 2002 to 2009. We used magnetic resonance imaging (MRI) to measure BDMprn. We calculated overall survival, recurrence-free and distant metastasis-free survival curves and set a BDMprn cut off point to categorize patients into a high- or low-risk group. We then used Cox proportional hazard model to evaluate the prognostic influence of BDMprn after correcting age, gender and chemotherapy status.
After adjusting for age, gender, and chemotherapy status, BDMprn remained an independent prognostic factor for distant metastasis [Hazard ratio (HR) = 1.046; P = 0.042] and overall survival (HR = 1.012; P = 0.012). Patients with BDMprn < 15 cm2 had a greater 3-year overall survival rate than those with BDMprn > or = 15 cm2 (92.3% vs. 73.7%; P = 0.009). They also had a greater 3-year distant metastasis-free survival (94% vs.75%; P = 0.034).
The predictive ability of BDMprn was validated in a separate NPC cohort. A BDMprn of 15 cm2 can be used to separate NPC patients into high- and low-risk groups and predict survival rates and metastasis potential. It can, therefore, be used as a reference to design clinical trials, predict prognosis, and make treatment decisions.
我们之前的研究表明，鼻咽癌（NPC）中计算机断层扫描（CT）得出的原发肿瘤和咽后淋巴结的二维测量（BDMprn）与原发肿瘤和咽后淋巴结的大体肿瘤体积（GTVprn）之间存在密切关系，BDMprn 较小的 NPC 患者预后更好。在这项研究中，我们报告了一项在另一批 NPC 患者中验证 BDM 使用的研究结果。
我们回顾性分析了 2002 年至 2009 年间接受放疗/同期放化疗（CCRT）或 CCRT 加辅助化疗治疗的 103 例新诊断 NPC 患者。我们使用磁共振成像（MRI）测量 BDMprn。我们计算了总生存、无复发和无远处转移生存曲线，并设定了 BDMprn 截断点，将患者分为高风险或低风险组。然后，我们使用 Cox 比例风险模型在校正年龄、性别和化疗状态后评估 BDMprn 的预后影响。
在校正年龄、性别和化疗状态后，BDMprn 仍然是远处转移的独立预后因素[危险比（HR）=1.046；P=0.042]和总生存（HR=1.012；P=0.012）。BDMprn<15cm2 的患者 3 年总生存率高于 BDMprn≥15cm2 的患者（92.3%比 73.7%；P=0.009）。他们也有更高的 3 年无远处转移生存率（94%比 75%；P=0.034）。
BDMprn 的预测能力在另一个 NPC 队列中得到了验证。BDMprn 的 15cm2 可以将 NPC 患者分为高风险和低风险组，并预测生存率和转移潜力。因此，它可以作为设计临床试验、预测预后和制定治疗决策的参考。
