Impact of paranasal sinus invasion on advanced nasopharyngeal carcinoma treated with intensity‐modulated radiation therapy: the validity of advanced T stage of AJCC/UICC eighth edition staging system

Cancer Medicine

Dengming Chen¹  Yuxiang He²  Zhanzhan Li²  Yajie Zhao²  Zhen Yang²  Ying Wang²  Liangfang Shen²  Rui Wei²  Mingjun Lei²  Jie Zhao³ 

[1] Department of Nuclear Medicine Xiangya Hospital Central South University Changsha China;Department of Oncology Xiangya Hospital Central South University No. 87, Xiangya Road Changsha Hunan Province 410008 China;Department of Radiology Xiangya Hospital Central South University Changsha China;

关键词: Intensity‐modulated radiation therapy;    nasopharyngeal carcinoma;    paranasal sinus;    prognosis;    staging;   

DOI  :  10.1002/cam4.1506

来源: DOAJ

【 摘 要 】

Abstract The aim of this study was to clarify the prognostic role of paranasal sinus invasion in advanced NPC patients. Data of patients (n = 295) with advanced NPC (T3/T4N0‐3 M0) treated with intensity‐modulated radiation therapy were retrospectively analyzed. Staging was according to the AJCC/UICC eighth edition staging system. Overall survival (OS), local recurrence‐free survival (LRFS), distant metastasis‐free survival (DMFS), and disease‐free survival (DFS) were calculated, and differences were compared between patients with and without paranasal sinus invasion. Multivariate analysis was used to identify the independent predictors of different survival parameters. Paranasal sinus invasion was present in 126 of 295 (42.7%) patients. Sphenoid, ethmoid, maxillary, and frontal sinus involvements were present in 123 of 295 (41.7%), 95 of 295 (32.2%), 45 of 295 (15.3%), and 0 of 295 (0%), respectively. All survival parameters were significantly better in patients without paranasal sinus invasion. When paranasal sinus invasion was reclassified as T4 instead of T3, all survival rates, other than LRFS (P = 0.156), were significantly better in the new T3 patients, and differences in all survival parameters remained nonsignificant between T3 with paranasal sinus invasion and T4 without paranasal sinus invasion patients (all P > 0.05). In multivariate analysis, paranasal sinus invasion was found to be an independent negative prognostic factor for OS, DFS, and DMFS (P = 0.016, P = 0.004, and P = 0.006, respectively), but not for LRFS (P = 0.068). Paranasal sinus invasion has prognostic value in advanced NPC. It may be reasonable to classify paranasal sinus invasion as T4 stage.

【 授权许可】

Unknown