Should all nasopharyngeal carcinoma with masticator space involvement be staged as T4?
Should all nasopharyngeal carcinoma with masticator space involvement be staged as T4?
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DOI：
10.1016/j.oraloncology.2014.09.001
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发表时间：
2014-12-01
期刊：
影响因子：
4.8
通讯作者：
Lee, Anne W. M.
中科院分区：
文献类型：
--
作者：
Sze, Henry;Chan, Lucy L. K.;Lee, Anne W. M.
简介：材料与方法：对1998 ~ 2010年1104例鼻咽癌根治性放疗后的非转移性患者，按第7版美国癌症联合委员会（AJCC）分期系统进行重新分期;翼内肌（MP）和/或翼外肌（LP）受累但不符合T3或T4标准的肿瘤分期为TX。比较不同T分期疾病的肿瘤体积、剂量学数据和生存终点，分析MS受累的意义。T1、T2、TX、T3和T4的原发性大体肿瘤体积的中值分别为9.6 ml、15.2 ml、19.9 ml、32.6 ml和77.3 ml（p < 0.001）。T1、T2和TX肿瘤接受的大体肿瘤体积和计划靶体积的最小剂量高于T3和T4。多因素分析显示，年龄、性别、T/N分类和化疗是影响各种生存终点的重要预后因素。TX疾病患者的生存率与T1-T2患者相似，5年总生存率显著高于T1-T2患者（86.6% vs. 76.6%; p = 0.013）和更高的5年远处无失败生存率趋势（91.5%vs81.3%，p = 0.09）。结论：单纯MP和/或LP累及的NPC应归类为T2期病变。(C)2014爱思唯尔有限公司版权所有。
Introduction: The prognostic significance of the involvement of anatomical masticator space (MS) in nasopharyngeal carcinoma (NPC) was retrospectively reviewed.Material and methods: 1104 Patients with non-metastatic NPC treated with radical radiotherapy between 1998 and 2010 were re-staged according to the 7th edition of the American Joint Committee on Cancer (AJCC) staging system; tumors with medial pterygoid muscle (MP) and/or lateral pterygoid muscle (LP) involvement but did not fulfill the criteria for T3 or T4 were staged as TX. The tumor volume data, dosimetric data and survival endpoints of different T stage diseases were analyzed and compared to study the significance of MS involvement.Results: The overall MS involvement rate was 61.0%. The median volumes of the primary gross tumor volume were 9.6 ml, 15.2 ml, 19.9 ml, 32.6 ml and 77.3 ml for T1, T2, TX, T3 and T4, respectively (p < 0.001). T1, T2 and TX tumors received higher minimum dose to the gross tumor volume and planning target volume than T3 and T4. Multivariate analysis showed that age, gender, T-/N-classification and the use of chemotherapy were significant prognostic factors for various survival end-points. Patients with TX disease had similar survival rates as with T1-T2; and had a significantly better 5-year overall survival rate (86.6% vs. 76.6%; p = 0.013) and a trend of higher 5-year distant failure-free survival rate (91.5% vs. 81.3%; p = 0.09) than patients with T3 disease.Conclusion: NPC with the involvement of MP and/or LP alone should be classified as T2 disease. (C) 2014 Elsevier Ltd. All rights reserved.