Cancer Res Treat.  2019 Jan;51(1):73-79. 10.4143/crt.2017.607.

Paranasal Sinus Invasion in Nasopharyngeal Carcinoma after Intensity-Modulated Radiotherapy

• Cao C
• Jiang F
• Jin Q
• Jin T
• Huang S
• Hu Q
• Chen Y
• Piao Y
• Hua Y
• Feng X
• Chen X

• KMID: 2437600
• DOI: http://doi.org/10.4143/crt.2017.607

Abstract

PURPOSE
The aim of this study is to evaluate the prognostic significance of paranasal sinus invasion for nasopharyngeal carcinoma (NPC) and its suitable position in the T classification.
MATERIALS AND METHODS
The magnetic resonance imaging (MRI) scans of 695 patients with previously untreated, biopsy-proven, non-metastatic NPC that was treated with intensity-modulated radiotherapy (IMRT) were reviewed retrospectively.
RESULTS
The incidence of paranasal sinus invasion was 39.4% (274 of 695 patients). Multivariate analysis showed that paranasal sinus invasion was an independent negative prognostic factor for local failure-free survival (LFFS) (p < 0.05). According to the eighth American Joint Committee on Cancer (AJCC) staging system, 275 patients were classified as T3 classification. Of these, 78 patients (28.4%) developed paranasal sinus invasion (T3b) and 197 (71.6%) didn't (T3a). The estimated 5-year LFFS and overall survival (OS) rates for the patients with T3b and T3a classification were 88.6% versus 95.0% (p=0.047), and 84.5% versus 93.3% (p=0.183), respectively. The estimated 5-year LFFS and OS rates for the patientswith T4 classificationwere 89.5% and 83.2%,whichwere similarwith the outcomes of patients with T3b classification.
CONCLUSION
MRI-determined paranasal sinus invasion is an independent prognostic factor of NPC treated by IMRT. Paranasal sinus invasion is recommended to classify as T4 classification in the 8th AJCC staging system for NPC.

Keyword

Nasopharyngeal carcinoma; Paranasal sinuses; Intensity-modulated radiotherapy; Prognostic value; American Joint Committee on Cancer staging system

MeSH Terms

Classification
Humans
Incidence
Joints
Magnetic Resonance Imaging
Multivariate Analysis
Paranasal Sinuses
Radiotherapy, Intensity-Modulated*
Retrospective Studies

Figure

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  Fig. 1. Paranasal sinus invasion in one patient with nasopharyngeal carcinoma. A coronal contrast-enhanced T1-weighted magnetic resonance image in a 52-year-old man show the sphenoid sinus invasion (arrow).

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  Fig. 2. Kaplan-Meier curve showing local failure-free survival (LFFS) (A), regional failure-free survival (RFFS) (B), distant metastasis-free survival (DMFS) (C), and overall survival (OS) rates (D) for the patients without and with paranasal sinus invasion (PSI) in the study.

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  Fig. 3. Probability of local failure-free survival (LFFS) (A) and overall survival (OS) rates (B) for patients with T3 classification and T4 classification according to the eighth American Joint Committee on Cancer (AJCC) staging system. T3b, T3 patients with paranasal sinus invasion; T3a, T3 patients without paranasal sinus invasion.

Reference

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