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Radiation Oncology
Published in: Radiation Oncology 1/2015

Open Access 01-12-2015 | Research

A retrospective study of the prognostic value of MRI-derived residual tumors at the end of intensity-modulated radiotherapy in 358 patients with locally-advanced nasopharyngeal carcinoma

Authors: Yuxiang He, Qin Zhou, Lin Shen, Yajie Zhao, Mingjun Lei, Rui Wei, Liangfang Shen, Shousong Cao

Published in: Radiation Oncology | Issue 1/2015

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Abstract

Objective

To retrospectively analyze the prognostic value of magnetic resonance imaging (MRI)-derived residual tumors after intensity-modulated radiation therapy (IMRT) in the patients with locally-advanced nasopharyngeal carcinoma.

Methods

A total of 358 patients with locally-advanced nasopharyngeal carcinoma who received IMRT were classified as having residual tumors or no residual tumor based on MRI at the end of radiotherapy. The χ2 test, log-rank test, Cox proportional hazards regression model and Kaplan-Meir survival curves were used to investigate the relationship of clinicopathological features and residual tumors and to assess the prognostic value of residual tumors.

Results

The 3-year overall survival (OS) rate was 73% in the residual tumor group and 90% in the no residual tumor group (HR 2.15, 95% CI 1.21-3.82,, P = 0.007); 3-year local relapse-free survival (LRFS) was 89% in the residual tumor group and 97% in the no residual tumor group (HR 4.46, 95% CI 1.61-12.38, P = 0.002); 3-year disease free survival (DFS) was 67% in the residual tumor group and 82% in the no residual tumor group (HR 2.21, 95% CI 1.40-3.48, P = 0.001). A high prescribed radiation dose (>73.92 Gy) did not increase the percentage volume of the GTVnx receiving 95% of the prescribed dose (GTVnx V95%) or improve any survival outcome.

Conclusion

The presence of a residual tumor after IMRT was a significant negative independent prognostic factor for OS, LRFS and DFS. Although IMRT have improved the distribution of radiotherapy doses into the tumors, residual tumors detected by MRI after IMRT are still associated with poor prognosis in patients with advanced nasopharyngeal carcinoma.
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Metadata
Title
A retrospective study of the prognostic value of MRI-derived residual tumors at the end of intensity-modulated radiotherapy in 358 patients with locally-advanced nasopharyngeal carcinoma
Authors
Yuxiang He
Qin Zhou
Lin Shen
Yajie Zhao
Mingjun Lei
Rui Wei
Liangfang Shen
Shousong Cao
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2015
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-015-0401-0

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