Proposed Lymph Node Staging System Using the International Consensus Guidelines for Lymph Node Levels Is Predictive for Nasopharyngeal Carcinoma Patients From Endemic Areas Treated With Intensity Modulated Radiation Therapy
Proposed Lymph Node Staging System Using the International Consensus Guidelines for Lymph Node Levels Is Predictive for Nasopharyngeal Carcinoma Patients From Endemic Areas Treated With Intensity Modulated Radiation Therapy
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DOI：
10.1016/j.ijrobp.2012.09.003
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发表时间：
2013-06-01
影响因子：
7
通讯作者：
Ma, Jun
中科院分区：
文献类型：
--
作者：
Li, Wen-Fei;Sun, Ying;Ma, Jun
目的：提出一个淋巴结（N）分期系统的基础上，国际共识指南的淋巴结（LN）的水平和MRI确定的nodal variables.Methods和Materials：MRI扫描和749例鼻咽癌患者接受调强放疗或化疗的病历进行了回顾性分析。分析了淋巴结水平、偏侧性、最大轴径、囊外扩散、坏死和国际癌症控制联盟/美国癌症联合委员会（UICC/AJCC）大小标准的预后意义。与单侧Ib、II、III和/或Va节段受累相比（风险比[HR] 1），单独的咽后淋巴结受累具有相似的预后价值（HR 0.71; 95%置信区间[CI] 0.43-1.17; P= 0.17），而双侧Ib、II、III和/或Va节段受累（HR 1.65; 95% CI 1.06-2.58; P=.03）和IV、Vb和/或锁骨上窝受累（HR 3.47; 95% CI 1.926.29; P
Purpose: To propose a lymph node (N) staging system for nasopharyngeal carcinoma (NPC) based on the International Consensus Guidelines for lymph node (LN) levels and MRI-determined nodal variables.Methods and Materials: The MRI scans and medical records of 749 NPC patients receiving intensity modulated radiation therapy with or without chemotherapy were retrospectively reviewed. The prognostic significance of nodal level, laterality, maximal axial diameter, extracapsular spread, necrosis, and Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) size criteria were analyzed.Results: Nodal level and laterality were the only independent prognostic factors for distant failure and disease failure in multivariate analysis. Compared with unilateral levels Ib, II, III, and/or Va involvement (hazard ratio [HR] 1), retropharyngeal lymph node involvement alone had a similar prognostic value (HR 0.71; 95% confidence interval [CI] 0.43-1.17; P=.17), whereas bilateral levels Ib, II, III, and/or Va involvement (HR 1.65; 95% CI 1.06-2.58; P=.03) and levels IV, Vb, and/or supraclavicular fossa involvement (HR 3.47; 95% CI 1.926.29; P