The Effect of Primary Tumor Volume Measured by Mr Imaging on T-Stage, Local Control, and Survival in Patients with Advanced Nasopharyngeal Carcinoma
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Purpose: To investigate the association of primary tumor volume by magnetic resonance imaging (MRI) with T-stage, and its prognostic influence on patients with advanced nasopharyngeal carcinoma (NPC). Materials and Methods: From February 2000 to May 2002, 69 biopsy-proven NPC; stage Ⅲ/Ⅳ disease, no distant metastasis and with available pre-treatment MRI were retrospectively reviewed. All patients received 10-weekly neoadjuvant chemotherapy followed by conventional fractionated radiotherapy of 70-74 Gy. The minimal follow- up time was 5 years. The primary tumor volume was delineated on the axial slides of T2-weighted images without contrast and calculated by the Eclipse(superscript TM) treatment planning software, Local-failure-free survival (LFFS), distant metastasis-free survival (DMFS), and overall survival (OS) were calculated by the Kaplan-Meier method. Results: The primary tumor volume for all patients ranged from 5.46 to 137.40 cm^3 with a median value of 17.12 cm^3 and a mean value of 25.36 cm^3. The primary tumor volume had positive correlation with T-stage. The median volume for T1-2, T3 and T4 tumors were 9.91 cm^3, 13.90 cm^3, and 27.26 cm^3, respectively (p＜0.0001). Five-year LFFS (90.6% vs. 87.1%, p=0.5056), DMFS (65.7% vs. 76.8%,: p-0.3656) and 05 (74.3% vs. 70.1%, p=0.9026) were not statistically different in patients with large : (volume 17 cm^3) and small (volume≧17 cm^3) primary tumor volume. The results are similar when the cutoff value is changed from the median to the mean values (≧and＜25 cm^3). When other cutoff values are used, the differences still don't achieve statistical significance. Conclusion: The primary tumor volume measured on T2-weighted non-contrast: enhanced MAI had positive correlation with T-staging but did not influence the prognosis of advanced NPC patients receiving neoadjuvant chemotherapy and radiotherapy.
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