磁共振成像检测颅神经侵犯对鼻咽癌的预后价值。
Prognostic value of magnetic resonance imaging-detected cranial nerve invasion in nasopharyngeal carcinoma.
机构信息
1] State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China [2] Department of Radiation Oncology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.
1] State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China [2] Imaging Diagnosis and Interventional Center, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.
出版信息
Br J Cancer. 2014 Mar 18;110(6):1465-71. doi: 10.1038/bjc.2014.27. Epub 2014 Feb 4.
BACKGROUND
We previously reported that magnetic resonance imaging evidence of cranial nerve invasion was an unfavourable prognostic factor in nasopharyngeal carcinoma. However, the prognostic value of this evidence in nasopharyngeal carcinoma treated with intensity-modulated radiotherapy remains unknown.
METHODS
We retrospectively analysed 749 nasopharyngeal carcinoma patients who underwent intensity-modulated radiotherapy.
RESULTS
Cranial nerve invasion was observed in 299 (39.9%) patients with T3-4 disease. In T3-4 nasopharyngeal carcinoma, magnetic resonance imaging-detected cranial nerve invasion was associated with inferior 5-year overall survival, distant metastasis-free survival, and locoregional relapse-free survival (P=0.002, 0.003, and 0.012, respectively). Multivariate analyses confirmed that cranial nerve invasion was an independent prognostic factor for distant metastasis-free survival (hazard ratio, 1.927; P=0.019) and locoregional relapse-free survival (hazard ratio, 2.605; P=0.032). Furthermore, the receiver-operating characteristic curves verified that the predictive validity of T classifications was significantly improved when combined with magnetic resonance imaging-detected cranial nerve invasion in terms of death, distant metastasis, and locoregional recurrence (P=0.015, 0.021 and 0.008, respectively).
CONCLUSIONS
Magnetic resonance imaging-detected cranial nerve invasion is an independent adverse prognostic factor in nasopharyngeal carcinoma treated with intensity-modulated radiotherapy.
背景
我们之前报道过，颅神经侵犯的磁共振成像证据是鼻咽癌的一个不利预后因素。然而，调强放疗治疗鼻咽癌患者中，该证据的预后价值尚不清楚。
方法
我们回顾性分析了 749 例接受调强放疗的鼻咽癌患者。
结果
在 T3-4 期疾病患者中，有 299 例（39.9%）观察到颅神经侵犯。在 T3-4 期鼻咽癌中，磁共振成像检测到的颅神经侵犯与较低的 5 年总生存率、无远处转移生存率和无局部区域复发生存率相关（P=0.002、0.003 和 0.012）。多因素分析证实，颅神经侵犯是无远处转移生存率（危险比，1.927；P=0.019）和无局部区域复发生存率（危险比，2.605；P=0.032）的独立预后因素。此外，受试者工作特征曲线验证了在 T 分类中加入磁共振成像检测到的颅神经侵犯可以显著提高死亡、远处转移和局部区域复发的预测准确性（P=0.015、0.021 和 0.008）。
结论
磁共振成像检测到的颅神经侵犯是调强放疗治疗鼻咽癌的一个独立不良预后因素。
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