title: Does MRI-detected cranial nerve involvement affect the prognosis of locally advanced nasopharyngeal carcinoma treated with intensity modulated radiotherapy?
abstract: Nasopharyngeal carcinoma (NPC) is one of the common cancers in South China. It can easily invade into cranial nerves, especially in patients with local advanced disease. Despite the fact that the magnetic resonance imaging (MRI) findings are not always consistent with the symptoms of CN palsy, MRI is recommended for the detection of CN involvement (CNI). However, the prognostic impact of MRI-detected CNI in NPC patients is still controversial. To investigate the prognostic value of MRI detected CNI, we performed a retrospective analysis on the clinical data of 375 patients with NPC who were initially diagnosed by MRI. All patients had T3-4 disease and received radical intensity modulated radiation therapy (IMRT) as their primary treatment. The incidence of MRI-detected CNI was 60.8%. A higher incidence of MRI-detected CNI was observed in T4 disease compared with T3 disease (96.8% vs. 42.8%, P<0.001), and a higher incidence was also found in patients with Stage IV disease compared with those with Stage III disease (91.5% vs. 42.3%; P<0.001). The local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) of patients with T3 disease, with or without MRI-detected CNI, was superior to that of patients with T4 disease (P<0.05). No significant differences in LRFS, DMFS or OS were observed between T3 patients with or without MRI-detected CNI. The survival of Stage III patients with or without MRI-detected CNI was significantly superior to that of Stage IV patients (P<0.01), but there was no significant difference between Stage III patients with or without MRI-detected CNI for all endpoints. Therefore, when treated with IMRT, MRI-detected CNI in patients with NPC does not appear to affect the prognosis. In patients with clinical T3 disease, the presence of MRI-detected CNI is not sufficient evidence for defining T4 disease.
authors: Provincial Clinical College, Fujian Medical University, Fuzhou City, Fujian Province, People's Republic of China; Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China.
authors: Jingfeng
authors: J
authors: Zong
authors: Provincial Clinical College, Fujian Medical University, Fuzhou City, Fujian Province, People's Republic of China; Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China.
authors: Shaojun
authors: S
authors: Lin
authors: Provincial Clinical College, Fujian Medical University, Fuzhou City, Fujian Province, People's Republic of China; Department of Radiology, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China.
authors: Yunbin
authors: Y
authors: Chen
authors: Provincial Clinical College, Fujian Medical University, Fuzhou City, Fujian Province, People's Republic of China; Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China.
authors: Bingyi
authors: B
authors: Wang
authors: Provincial Clinical College, Fujian Medical University, Fuzhou City, Fujian Province, People's Republic of China; Department of Radiology, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China.
authors: Youping
authors: Y
authors: Xiao
authors: Provincial Clinical College, Fujian Medical University, Fuzhou City, Fujian Province, People's Republic of China; Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China.
authors: Jin
authors: J
authors: Lin
authors: Provincial Clinical College, Fujian Medical University, Fuzhou City, Fujian Province, People's Republic of China; Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China.
authors: Rui
authors: R
authors: Li
authors: Provincial Clinical College, Fujian Medical University, Fuzhou City, Fujian Province, People's Republic of China; Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian Provincial Cancer Hospital, Fuzhou City, Fujian Province, People's Republic of China.
authors: Jianji
authors: J
authors: Pan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma; D002648:Child; D003391:Cranial Nerves / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011379:Prognosis; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult