MR imaging prediction of local control of nasopharyngeal carcinoma treated with radiation therapy and chemotherapy.
OBJECTIVE
To retrospectively evaluate the association of MRI findings with local control of nasopharyngeal carcinoma (NPC) treated with radiation therapy and chemotherapy (chemoradiotherapy).


METHODS
Pre-treatment MRIs of 101 patients (78 males and 23 females, 23-79 years of age) who had NPC treated with chemoradiotherapy were retrospectively reviewed to evaluate tumour involvement of nasopharyngeal anatomic subsites, tumour volume and MRI appearance. Local control rates were evaluated with respect to these MRI findings.


RESULTS
Univariate analysis (using the Kaplan-Meier method) showed that invasion of the skull base as determined by MRI was a significant predictor of local control. In terms of clinical characteristics, T stage and pathological subtype were significant predictors of local control. Multivariate analysis (Cox regression model) of the radiologic findings and clinical characteristics revealed that invasion of the skull base (p = 0.003) and pathological subtype (p < 0.001) were independent prognostic factors for local control.


CONCLUSIONS
Invasion of the skull base as determined by MRI predicts the likelihood of local failure and may be helpful in identifying a subset of patients with tumours at risk of local recurrence within 3 years after primary chemoradiotherapy.


CONCLUSIONS
It has now become common practice to use MRI for pre-treatment evaluation of patients with NPC. The potential role for MRI findings in predicting local control and prognosis in patients with NPC has implications for treatment planning.
1 Department of Radiology, The 5th Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Zhuhai, China.
Y
Y
Wang
H
H
Zhao
Z-Q
ZQ
Zhang
L-L
LL
Huang
Y
Y
Ye
Y-B
YB
Wang
M-J
MJ
Han
D000328:Adult; D000368:Aged; D002277:Carcinoma; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000517:prevention & control / Q000532:radiotherapy*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000473:pathology; D055815:Young Adult