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document
MRI-detected skull-base invasion : prognostic value and therapeutic implication in intensity-modulated radiotherapy treatment for nasopharyngeal carcinoma . PURPOSE With advances in imaging and radiotherapy , the prognostic value of skull-base invasion in nasopharyngeal carcinoma ( NPC ) needs to be reassessed . We aimed to define a classification system and evaluate the prognostic value of the classification of magnetic resonance imaging ( MRI ) -detected skull-base invasion in NPC treated with intensity-modulated radiotherapy ( IMRT ) . PATIENTS AND MATERIALS We retrospectively reviewed 749 patients who underwent MRI and were subsequently histologically diagnosed with nondisseminated NPC and treated with IMRT . RESULTS MRI-detected skull-base invasion was not found to be an independent prognostic factor for overall survival ( OS ) , distant metastasis-free survival ( DMFS ) , local relapse-free survival ( LRFS ) , or disease-free survival ( DFS ; p > 0.05 for all ) . Skull-base invasion was classified according to the incidence of each site ( type I sites inside pharyngobasilar fascia and clivus vs. type II sites outside pharyngobasilar fascia ) . The 5-year OS , DMFS , LRFS , and DFS rates in the classification of skull-base invasion in NPC were 83 vs. 67 % , 85 vs.75 % , 95 vs. 88 % , and 76 vs. 62 % , respectively ( p < 0.05 for all ) . Multivariate analysis indicated the classification of skull-base invasion was an independent prognostic factor . CONCLUSION MRI-detected skull-base invasion is not an independent prognostic factor in patients with NPC treated with IMRT . However , classification according to the site of invasion has prognostic value . Therefore , patients with various subclassifications of stage T3 disease may receive treatment with different intensities ; however , further studies are warranted to prove this .
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Intervention_Physical
intensity-modulated radiotherapy
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Intervention_Physical
MRI and were subsequently histologically diagnosed with nondisseminated NPC and treated with IMRT
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Outcome_Mortality
overall survival ( OS ) , distant metastasis-free survival ( DMFS ) , local relapse-free survival ( LRFS ) , or disease-free survival ( DFS ;
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Outcome_Mortality
5-year OS
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Outcome_Mortality
DMFS
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Outcome_Mortality
LRFS
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Outcome_Mortality
DFS
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Participant_Condition
nasopharyngeal carcinoma .
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Participant_Sample-size
749
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Participant_Condition
nondisseminated NPC