The New T Staging System for Nasopharyngeal Carcinoma Based on Intensity Modulated Radiation Therapy: Results of a Prospective Multicentric Clinical Study

Kang, Min; Zhou, Pingting; Wei, Tingting; Long, Jianxiong; Li, G.; Huang, Yan; Feng, Guosheng; Liu, M.; Jin, Zhu; Wang, R.

doi:10.1016/j.ijrobp.2016.06.1489

Cited by 8 publications

(12 citation statements)

References 36 publications

(51 reference statements)

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“…Moreover, when we regrouped the T classifications as two groups (T1+T2+T3 vs. T4), the HRs of 8 th editions (HR = 3.070, 95%CI = 1.813-5.197, P=0.001) between adjacent T stages were smaller than in the 7th editions (HR = 5.085, 95% CI = 1.846-14.008, P=0.002). Consequently, our previous study had suggested that the T classifications should be subdivided into two stages rather than four stages [ 11 , 12 ]. Since our current study shows that there is no statistical difference between adjacent T stages using the 8 th edition of the UICC/AJCC staging system, the T classification using the 8 th edition remains controversial.…”

Section: Discussionmentioning

confidence: 99%

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Validation of the 8th edition of the UICC/AJCC staging system for nasopharyngeal carcinoma treated with intensity-modulated radiotherapy

Kang

Zhou

Li³

et al. 2017

Oncotarget

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An accurate TNM staging system is crucial for treatment guidance and prognosis prediction in nasopharyngeal carcinoma (NPC) patients. In this retrospective study, we evaluated the 8th edition of the Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) staging system for NPC treated with intensity-modulated radiotherapy (IMRT). A total of 608 patients with biopsy-proven, non-metastatic NPC, treated with IMRT between January 2008 and March 2010, were enrolled. The 5-year overall survival (OS), disease-free survival (DFS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) rates were 81.5%, 80.1%, 86.0%, and 81.1%, respectively. The LRFS rates of patients with stages T1 vs. T2, T2 vs. T3, and T1 vs. T3 did not differ between the 7th and 8th editions. By contrast, the DMFS rates of patients with N0 vs. N1, N1 vs. N2, and N2 vs. N3 differed between the 8th and the 7th editions, though no difference was observed between N3a and N3b, according to the 7th edition. The difference in OS between stages II and III, and between stages III and IVa, was larger according to the 8th edition than the 7th edition. There was no difference in the OS between stages I and II. These data indicate that in the IMRT era, the 8th edition staging system can predict the prognosis of NPC patients more accurately than the 7th edition.

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Section: Discussionmentioning

confidence: 99%

“…All targets were treated once daily and 5 times weekly, for a total fraction of 30-33 Gy. The details of the IMRT treatment were reported in our previous studies [ 11 , 12 ].…”

Section: Methodsmentioning

confidence: 99%

Validation of the 8th edition of the UICC/AJCC staging system for nasopharyngeal carcinoma treated with intensity-modulated radiotherapy

Kang

Zhou

Li³

et al. 2017

Oncotarget

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“…Previous studies have showed that the invasions in the nasal cavity, pharynx oralis, parapharyngeal space, medial pterygoid, lateral pterygoid, infratemporal fossa, paranasal sinuses, orbit, intracalvarium, and cranial nerves are all in-dependent prognostic factors [ 13 , 14 ]. According to the risk difference and survival curve distribution analyses, it is suggested that the new clinical T staging standards for nasopharyngeal carcinoma based on MRI and IMRT should include: T1, nasopharynx, pharynx, oropharynx, nasal cavity, skull base, and medial pterygoid; and T2, lateral pterygoid, cavernous sinus, paranasal sinuses, infratemporal fossa, orbit, intracalvarium, and cranial nerves.…”

Section: Discussionmentioning

confidence: 99%

“…The new T staging criteria included [ 13 , 14 ]: T1, invasion in nasopharynx, parapharyngeal space, oropharynx, nasal cavity, skull base, and medial pterygoid; and T2, invasion in lateral pterygoid, paranasal sinuses, orbit, intracalvarium, infratemporal fossa, and cranial nerves. On the other hand, the new N staging criteria were as follows [ 15 ]: N0, with no lymph node metastasis; N1, lymph node metastasis in the VIIa region and/or unilateral upper cervical region (I, II, III, and Va regions); N2, lymph node metastasis in the bilateral upper cervical regions (I, II, III, and Va regions); and N3, lymph node metastasis in the IVa and Vb regions, as well as the lower regions.…”

Section: Methodsmentioning

confidence: 99%

“…In a large number of studies, the seventh edition of the International Union against Cancer/American Joint Committee on Cancer (UICC/AJCC) staging system based on conventional radiographic data has been shown to be deficient in predicting the prognosis of patients with NPC [ 6 – 8 ], and there are numerous studies concerning the staging systems of nasopharyngeal carcinoma [ 9 – 12 ]. A preliminary study from our laboratory has developed the new T and N staging systems for NPC according to the MRI and IMRT [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

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A new staging system for nasopharyngeal carcinoma based on intensity-modulated radiation therapy (IMRT)

et al. 2017

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ObjectiveThis study is to establish a new staging system for nasopharyngeal carcinoma (NPC) based on the magnetic resonance imaging (MRI) and intensity-modulated radiation therapy (IMRT).MethodsTotally 492 patients with nasopharyngeal carcinoma were included in this study. These patients were diagnosed by pathological detection (without distant metastasis) and underwent the initial treatment of IMRT. These patients were subjected to the staging with the International Union against Cancer/American Joint Committee on Cancer (UICC/AJCC) staging system. Survival rates were calculated by the Kaplan-Meier method. Log-rank test was used to calculate the single factor prognosis, and the COX risk model was used to analyze the multivariate prognosis.ResultsIn these 492 patients, according to our recommended new T and N staging criteria, there were 290 cases of T1 and 202 cases of T2; there were 64 cases of N0, 159 cases of N1, 226 cases of N2, and 43 cases of N3. Univariate and multivariate analyses showed that the T and N staging combination parameters were independent prognostic factors, which affected the overall survival rates and tumor-free survival rates. According to risk difference and survival curve distribution, the following new clinical staging criteria were established: stage I (T1N0M0), stage II (T1N1M0 and T2N0M0), stage III (T1N2M0 and T2N1-2M0), stage IVa (T1-2N3M0), and stage IVb (TxNxM1).ConclusionA new staging system for NPC based on MRI and IMRT has been recommended, which provides valuable evidence for disease treatment and prognosis prediction.

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CircFOXM1 acts as a ceRNA to upregulate SMAD2 and promote the progression of nasopharyngeal carcinoma

Pei

Chen

et al. 2022

Molec Gen & Gen Med

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Background In recent years, the development of high‐throughput sequencing technology has promoted the rapid development of circRNA‐related research. Studies have found that circRNA plays a key role in a variety of tumors, but few people study the role of circRNA in nasopharyngeal carcinoma. Under comprehensive treatments, the 5‐year survival rate can reach about 70%, but some patients still have distant metastases or recurrences after treatment. Therefore, it is very important to study the molecular mechanisms of the proliferation and invasion of nasopharyngeal carcinoma. Methods QRT‐PCR was applied to detect the relative expression level of circFOXM1 in NPC and nasopharyngeal epithelial cell lines. We knocked down circFOXM1 and studied the influence of circFOXM1 on NPC cells. Nuclear and cytoplasmic RNA isolation experiments, fluorescence in situ hybridization (FISH), bioinformatics analysis, the dual‐luciferase reporter experiment, Western Blot, and other experiments were conducted to verify the relationships among circFOXM1, miR‐136‐5p, and SMAD2 . We collected clinical NPC samples to prove the effect of circFOXM1 on the prognosis and treatment of NPC. Results In this study, we found that circFOXM1 is highly expressed in nasopharyngeal carcinoma tissue cells compared with adjacent normal tissues and is related to the staging of nasopharyngeal carcinoma. High expression of circFOXM1 indicates a poor prognosis for nasopharyngeal carcinoma. Knockdown of CircFOXM1 inhibited the proliferation and invasion of nasopharyngeal carcinoma cells. Conclusion CircFOXM1 promotes the malignant proliferation of nasopharyngeal carcinoma cells by regulating the miR‐136‐5p‐SMAD2 axis.

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The New T Staging System for Nasopharyngeal Carcinoma Based on Intensity Modulated Radiation Therapy: Results of a Prospective Multicentric Clinical Study

Cited by 8 publications

References 36 publications

Validation of the 8th edition of the UICC/AJCC staging system for nasopharyngeal carcinoma treated with intensity-modulated radiotherapy

Validation of the 8th edition of the UICC/AJCC staging system for nasopharyngeal carcinoma treated with intensity-modulated radiotherapy

A new staging system for nasopharyngeal carcinoma based on intensity-modulated radiation therapy (IMRT)

CircFOXM1 acts as a ceRNA to upregulate SMAD2 and promote the progression of nasopharyngeal carcinoma

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