肿瘤体积/代谢信息能否改善鼻咽癌基于解剖学的分期系统的预后评估？对美国癌症联合委员会/国际抗癌联盟第8版鼻咽癌分期系统的评估。

Tumor volume/metabolic information can improve the prognostication of anatomy based staging system for nasopharyngeal cancer? Evaluation of the 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer.

作者信息

Jeong Yuri, Lee Sang-Wook

机构信息

Department of Radiation Oncology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea.

Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Radiat Oncol J. 2018 Dec;36(4):295-303. doi: 10.3857/roj.2018.00430. Epub 2018 Dec 31.

DOI:10.3857/roj.2018.00430

PMID:30630268

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6361247/

Abstract

PURPOSE

We evaluated prognostic value of the 8th edition of the American Joint Committee on Cancer/International Union for Cancer Control (AJCC/UICC) staging system for nasopharyngeal cancer and investigated whether tumor volume/metabolic information refined prognostication of anatomy based staging system.

MATERIALS AND METHODS

One hundred thirty-three patients with nasopharyngeal cancer who were staged with magnetic resonance imaging (MRI) and treated with intensity-modulated radiotherapy (IMRT) between 2004 and 2013 were reviewed. Multivariate analyses were performed to evaluate prognostic value of the 8th edition of the AJCC/UICC staging system and other factors including gross tumor volume and maximum standardized uptake value of primary tumor (GTV-T and SUV-T).

RESULTS

Median follow-up period was 63 months. In multivariate analysis for overall survival (OS), stage group (stage I-II vs. III- IVA) was the only significant prognostic factor. However, 5-year OS rates were not significantly different between stage I and II (100% vs. 96.2%), and between stage III and IVA (80.1% vs. 71.7%). Although SUV-T and GTV-T were not significant prognostic factors in multivariate analysis, those improved prognostication of stage group. The 5-year OS rates were significantly different between stage I-II, III-IV (SUV-T ≤ 16), and III-IV (SUV-T > 16) (97.2% vs. 78% vs. 53.8%), and between stage I, II-IV (GTV-T ≤ 33 mL), and II-IV (GTV-T > 33 mL) (100% vs. 87.3% vs. 66.7%).

CONCLUSION

Current anatomy based staging system has limitations on prognostication for nasopharyngeal cancer despite the most accurate assessment of tumor extent by MRI. Tumor volume/metabolic information seem to improve prognostication of current anatomy based staging system, and further studies are needed to confirm its clinical significance.

摘要

目的

我们评估了美国癌症联合委员会/国际癌症控制联盟（AJCC/UICC）第8版鼻咽癌分期系统的预后价值，并研究肿瘤体积/代谢信息是否能完善基于解剖学的分期系统的预后评估。

材料与方法

回顾了2004年至2013年间133例接受磁共振成像（MRI）分期并接受调强放疗（IMRT）的鼻咽癌患者。进行多因素分析以评估AJCC/UICC第8版分期系统及其他因素（包括肿瘤总体积和原发肿瘤的最大标准化摄取值（GTV-T和SUV-T））的预后价值。

结果

中位随访期为63个月。在总生存（OS）的多因素分析中，分期组（I-II期 vs. III-IVA期）是唯一显著的预后因素。然而，I期和II期之间（100% vs. 96.2%）以及III期和IVA期之间（80.1% vs. 71.7%）的5年总生存率无显著差异。尽管SUV-T和GTV-T在多因素分析中不是显著的预后因素，但它们改善了分期组的预后评估。I-II期、III-IV期（SUV-T≤16）和III-IV期（SUV-T>16）之间的5年总生存率有显著差异（97.2% vs. 78% vs. 53.8%），I期、II-IV期（GTV-T≤33 mL）和II-IV期（GTV-T>33 mL）之间的5年总生存率也有显著差异（100% vs. 87.3% vs. 66.7%）。