Clinical application of tumor volume in advanced nasopharyngeal carcinoma to predict outcome

Abstract

BackgroundCurrent staging systems have limited ability to adjust optimal therapy in advanced nasopharyngeal carcinoma (NPC). This study aimed to delineate the correlation between tumor volume, treatment outcome and chemotherapy cycles in advanced NPC.MethodsA retrospective review of 110 patients with stage III-IV NPC was performed. All patients were treated first with neoadjuvant chemotherapy, then concurrent chemoradiation, and followed by adjuvant chemotherapy as being the definitive therapy. Gross tumor volume of primary tumor plus retropharyngeal nodes (GTVprn) was calculated to be an index of treatment outcome.ResultsGTVprn had a close relationship with survival and recurrence in advanced NPC. Large GTVprn (≧13 ml) was associated with a significantly poorer local control, lower distant metastasis-free rate, and poorer survival. In patients with GTVprn ≧ 13 ml, overall survival was better after ≧4 cycles of chemotherapy than after less than 4 cycles.ConclusionsThe incorporation of GTVprn can provide more information to adjust treatment strategy.

Diffusion-Weighted Imaging of Nasopharyngeal Carcinoma: Can Pretreatment DWI Predict Local Failure Based on Long-Term Outcome?

“…[27][28][29][30][31][32][33][34][35] This finding was also a trend in this study but did not reach significance, possibly because the mean volume of our primary tumors (24.6 mL) was in the lower range of previously reported cutoff thresholds, which have ranged from 13 to 60 mL. [27][28][29][30][31][32][33][34][35] In addition, the T-stage was not significant. This finding is possibly explained by the better treatment outcomes as a result of intensity-modulated radiation therapy 36 and also the wide use of MR imaging for staging, which can lead to upstaging to T3 disease as a result of greater sensitivity to bone invasion compared with CT. 37 Histologic NPC subtype also has a major influence on treatment outcome, whereby the undifferentiated form of NPC has a better prognosis than the other subtypes.…”

Should all nasopharyngeal carcinoma with masticator space involvement be staged as T4?

“…Previous studies have demonstrated a predictive role of tumor volume in the treatment outcome regardless of the radiotherapy techniques [17][18][19][20][21][22]. It was estimated that the local failure increased by 1% for every 1 cm 3 increase in tumor volume [18].…”

Photodynamic therapy as an effective therapeutic approach in MAME models of inflammatory breast cancer

“…In this respect, mathematical algorithms for 3D modeling of patient tumors and prediction of surgical volume better assess breast tumor stage and response to therapies [48, 49]. The volume of nasopharyngeal carcinoma rather than their size is associated with poorer survival and faster recurrence [50–52]. Here we measured the volume of MAME structures to determine if this parameter could be used to quantify response to combination PDT (Fig.…”