PROGNOSTIC IMPACT OF TUMOR VOLUME IN PATIENTS WITH STAGE III-IVA HYPOPHARYNGEAL CANCER WITHOUT BULKY LYMPH NODES TREATED WITH DEFINITIVE CONCURRENT CHEMORADIOTHERAPY
PROGNOSTIC IMPACT OF TUMOR VOLUME IN PATIENTS WITH STAGE III-IVA HYPOPHARYNGEAL CANCER WITHOUT BULKY LYMPH NODES TREATED WITH DEFINITIVE CONCURRENT CHEMORADIOTHERAPY
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DOI：
10.1002/hed.21011
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发表时间：
2009-06-01
影响因子：
2.9
通讯作者：
Tsai, Ming-Hsui
中科院分区：
文献类型：
--
作者：
Chen, Shang-Wen;Yang, Shih-Neng;Tsai, Ming-Hsui
背景探讨容积分析在同期放化疗（CCRT）治疗的III-IVA期下咽癌患者中的预后价值。76例没有巨大淋巴结的III-IVA期下咽癌患者入组进行体积分析。梨状窝是63例的主要受累部位。所有患者均接受一个疗程的CCRT。肿瘤体积测量使用原发肿瘤体积（pGTV）和淋巴结肿瘤体积（nGTV）的单独计算得出。pGTV范围为3.8至152.4 mL（平均值为33.4 mL）。对于pGTV = 30 mL的患者，3年病因特异性生存率（CSS）为75%< 30 mL and 20% when the pGTV was >（p = .0001）。此外，对于pGTV = 30 mL的患者，3年原发性肿瘤无复发生存率（PRFS）为72%< 30 mL and 23% when the pGTV were >（p = .0001）。对于< 30 mL and >≥ 30 mL的III期疾病，3年PRFS分别为74%和25%（p = .01），对于IVA期肿瘤，分别为65%和22%（p = .01）。CSS的多变量分析揭示了一个单一的预后因素，即pGTV < 30 mL versus >= 30 mL（p = 0.0001，风险比2.84）。PRFS的多变量分析得出了类似的结果，pGTV >= 30 mL（p = .0001，风险比2.55）具有显著性。结论。患者的pGTV是使用CCRT治疗下咽癌的强有力的结果预测因子。因此，选择一组患者，主要是肿瘤体积< 30 mL的患者，应考虑保留喉。(c)2009 Wiley Periodicals，Inc.头颈部31：709-716，2009年
Background. To investigate the prognostic value of volumetric analysis in patients with stage III-IVA hypopharyngeal cancer treated with concurrent chemoradiotherapy (CCRT).Methods. Seventy-six stage III-IVA hypopharyngeal cancer patients without bulky lymph nodes were enrolled for a volumetric analysis. The pyriform sinus was the principal site of involvement in the 63 cases. All patients were allocated a course of CCRT. Tumor volume measurement was derived using separate calculations for the primary tumor volume (pGTV) and the nodal tumor volume (nGTV).Results. The pGTV ranged from 3.8 to 152.4 mL (mean, 33.4 mL). The 3-year cause-specific survival (CSS) was 75% for those with a pGTV < 30 mL and 20% when the pGTV was >= 30 mL (p = .0001). Furthermore, the 3-year primary tumor relapse-free survival (PRFS) was 72% for those with a pGTV < 30 mL and 23% when the pGTV were >= 30 mL (p = .0001). The 3-year PRFSs for < 30 mL and >= 30 mL were 74% and 25% for stage III disease (p = .01) and 65% and 22% for stage IVA tumors (p = .01), respectively. Multivariate analyses of the CSS revealed a single prognostic factor, namely pGTV < 30 mL versus >= 30 mL (p = .0001, hazard ratio 2.84). Multivariate analyses of the PRFS gave a similar finding, with a pGTV >= 30 mL (p = .0001, hazard ratio 2.55) being significant.Conclusion. A patient's pGTV is a strong outcome predictor for hypopharyngeal cancer treatment using CCRT. Therefore, a selected group of patients, mainly those with tumor volumes < 30 mL should be considered for laryngeal preservation. (c) 2009 Wiley Periodicals, Inc. Head Neck 31: 709-716, 2009