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A Study of 358 Cases of Locally Advanced Nasopharyngeal Carcinoma Receiving Intensity-Modulated Radiation Therapy: Improving the Seventh Edition of the American Joint Committee on Cancer T-Staging System.

Abstract To evaluate the rationality and limitations of the seventh edition of the American Joint Committee on Cancer (the 7th AJCC edition) T-staging system for locally advanced nasopharyngeal carcinoma (NPC). The prognosis of 358 patients with stage T3/T4 NPC treated with intensity-modulated radiotherapy (IMRT) was analyzed with the Kaplan-Meier method or the log-rank test. The 7th AJCC staging system of NPC has some limitations in that the T category is neither the significant factor in OS/LRFS nor the independent prognostic factor in OS/LRFS/DMFS/DFS (P > 0.05). After adjustment by anatomic structures, univariate analysis has shown that the adjusted-T category has statistical significance between T3 and T4 for OS (86.4% and 71.3%, P = 0.002), LRFS (97% and 90.9%, P = 0.048), DMFS (90.9% and 77.2%, P = 0.001), and DFS (86.2% and 67.5%, P = 0.000), and multivariate analysis has shown that the adjusted-T category is an independent prognostic factor for OS/DMFS/DFS (with the exception of LRFS). Then, GTV-P was taken into consideration. Multivariate analysis showed that these nT categories serve as suitable independent prognostic factors for OS/DMFS/DFS (P < 0.001) and LRFS (HR = 3.131; 95% CI, 1.090-8.990; P = 0.043). The 7th AJCC staging system has limitations and should be improved by including the modifications suggested, such as anatomic structures and tumor volume adjustment.
PMID
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Authors

Mayor MeshTerms

Radiotherapy, Intensity-Modulated

Keywords
Journal Title biomed research international
Publication Year Start




PMID- 28265567
OWN - NLM
STAT- MEDLINE
DA  - 20170307
DCOM- 20170309
LR  - 20170309
IS  - 2314-6141 (Electronic)
VI  - 2017
DP  - 2017
TI  - A Study of 358 Cases of Locally Advanced Nasopharyngeal Carcinoma Receiving
      Intensity-Modulated Radiation Therapy: Improving the Seventh Edition of the
      American Joint Committee on Cancer T-Staging System.
PG  - 1419676
LID - 10.1155/2017/1419676 [doi]
AB  - To evaluate the rationality and limitations of the seventh edition of the
      American Joint Committee on Cancer (the 7th AJCC edition) T-staging system for
      locally advanced nasopharyngeal carcinoma (NPC). The prognosis of 358 patients
      with stage T3/T4 NPC treated with intensity-modulated radiotherapy (IMRT) was
      analyzed with the Kaplan-Meier method or the log-rank test. The 7th AJCC staging 
      system of NPC has some limitations in that the T category is neither the
      significant factor in OS/LRFS nor the independent prognostic factor in
      OS/LRFS/DMFS/DFS (P &gt; 0.05). After adjustment by anatomic structures, univariate 
      analysis has shown that the adjusted-T category has statistical significance
      between T3 and T4 for OS (86.4% and 71.3%, P = 0.002), LRFS (97% and 90.9%, P =
      0.048), DMFS (90.9% and 77.2%, P = 0.001), and DFS (86.2% and 67.5%, P = 0.000), 
      and multivariate analysis has shown that the adjusted-T category is an
      independent prognostic factor for OS/DMFS/DFS (with the exception of LRFS). Then,
      GTV-P was taken into consideration. Multivariate analysis showed that these nT
      categories serve as suitable independent prognostic factors for OS/DMFS/DFS (P &lt; 
      0.001) and LRFS (HR = 3.131; 95% CI, 1.090-8.990; P = 0.043). The 7th AJCC
      staging system has limitations and should be improved by including the
      modifications suggested, such as anatomic structures and tumor volume adjustment.
FAU - Zhou, Qin
AU  - Zhou Q
AD  - Department of Oncology, Xiangya Hospital, Central South University, No. 87,
      Xiangya Road, Changsha, Hunan Province 410008, China.
FAU - He, Yuxiang
AU  - He Y
AD  - Department of Oncology, Xiangya Hospital, Central South University, No. 87,
      Xiangya Road, Changsha, Hunan Province 410008, China.
FAU - Zhao, Yajie
AU  - Zhao Y
AD  - Department of Oncology, Xiangya Hospital, Central South University, No. 87,
      Xiangya Road, Changsha, Hunan Province 410008, China.
FAU - Wang, Yin
AU  - Wang Y
AD  - Department of Oncology, Xiangya Hospital, Central South University, No. 87,
      Xiangya Road, Changsha, Hunan Province 410008, China.
FAU - Kuang, Weilu
AU  - Kuang W
AD  - Department of Oncology, Xiangya Hospital, Central South University, No. 87,
      Xiangya Road, Changsha, Hunan Province 410008, China.
FAU - Shen, Liangfang
AU  - Shen L
AUID- ORCID: 0000-0002-6488-6221
AD  - Department of Oncology, Xiangya Hospital, Central South University, No. 87,
      Xiangya Road, Changsha, Hunan Province 410008, China.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20170207
PL  - United States
TA  - Biomed Res Int
JT  - BioMed research international
JID - 101600173
RN  - Nasopharyngeal carcinoma
SB  - IM
MH  - Adult
MH  - Aged
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nasopharyngeal Neoplasms/*mortality/pathology/*radiotherapy
MH  - Neoplasm Staging
MH  - *Radiotherapy, Intensity-Modulated
MH  - Survival Rate
PMC - PMC5318629
COI - The authors declare that there is no conflict of interests regarding the
      publication of this paper.
EDAT- 2017/03/08 06:00
MHDA- 2017/03/10 06:00
CRDT- 2017/03/08 06:00
PHST- 2016/09/20 [received]
PHST- 2016/11/30 [revised]
PHST- 2016/12/28 [accepted]
AID - 10.1155/2017/1419676 [doi]
PST - ppublish
SO  - Biomed Res Int. 2017;2017:1419676. doi: 10.1155/2017/1419676. Epub 2017 Feb 7.

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