title: T4-locally advanced nasopharyngeal carcinoma: prognostic influence of cranial nerve involvement in different radiotherapy techniques.
abstract: BACKGROUND
  Cranial nerve involvement at disease presentation of nasopharyngeal carcinoma was not uncommon. We investigated the prognosis of patients with T4-locally advanced NPC, with or without cranial nerve involvement, and compared the outcome of patients treated using different radiotherapy techniques.
  
  
  METHODS
  In this retrospective study, 83 T4-locally advanced NPC patients were diagnosed according to the seventh edition of the American Joint Committee on Cancer staging system. All patients were treated using three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiation therapy (IMRT). The survival rate was analyzed using the Kaplan-Meier method.
  
  
  RESULTS
  The 5-year overall, locoregional-free, and disease-free survival rates of patients treated using IMRT were 88.9%, 75.2%, and 69.2%, respectively. The outcome in these patients was significantly better than that in patients treated using 3D-CRT, with survival rates of 58.2%, 54.4%, and 47.2%, respectively. There was no significant difference in the 5-year overall, locoregional-free, and disease-free survival rates of the patients with (64.2%, 60.5%, and 53.5%, resp.) and without (76.9%, 63.6%, and 57.6%, resp.) cranial nerve involvement.
  
  
  CONCLUSIONS
  Locally advanced NPC patients treated using IMRT had significantly better outcomes than patients treated using 3D-CRT. Our results showed that the outcome of T4 NPC patients with or without cranial nerve involvement was not different.
authors.affiliation: Department of Otolaryngology, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei City 11217, Taiwan ; School of Medicine, National Yang-Ming University, No. 201, Section 2, Shih-Pai Road, Taipei City 11217, Taiwan.
authors.forename: Hsin-I
authors.initials: HI
authors.lastname: Huang
authors.affiliation: Department of Otolaryngology, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei City 11217, Taiwan ; School of Medicine, National Yang-Ming University, No. 201, Section 2, Shih-Pai Road, Taipei City 11217, Taiwan.
authors.forename: Kee-Tak
authors.initials: KT
authors.lastname: Chan
authors.affiliation: Department of Otolaryngology, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei City 11217, Taiwan ; School of Medicine, National Yang-Ming University, No. 201, Section 2, Shih-Pai Road, Taipei City 11217, Taiwan.
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Shu
authors.affiliation: Department of Otolaryngology, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei City 11217, Taiwan ; School of Medicine, National Yang-Ming University, No. 201, Section 2, Shih-Pai Road, Taipei City 11217, Taiwan.
authors.forename: Ching-Yin
authors.initials: CY
authors.lastname: Ho
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma; D003391:Cranial Nerves / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods*; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology