Patterns of Primary Tumor Invasion and Regional Lymph Node Spread Based on Magnetic Resonance Imaging in Early-Stage Nasal NK/T-cell Lymphoma: Implications for Clinical Target Volume Definition and Prognostic Significance
Purpose: This study aimed to determine the pathways of primary tumor invasion (PTI) and regional lymph node (LN) spread based on magnetic resonance imaging (MRI) in early-stage nasal NK/T-cell lymphoma (NKTCL), to improve clinical target volume (CTV) delineation and evaluate the prognostic value of locoregional extension patterns.Methods and Materials: A total of 105 patients with newly diagnosed early-stage nasal NKTCL who underwent pretreatment MRI were retrospectively reviewed.All patients received radiation therapy with or without chemotherapy.Results: The incidences of PTI and regional LN involvement were 64.7% and 25.7%,respectively.Based on the incidence of PTI, involved sites surrounding the nasal cavity were classified into 3 risk subgroups: high-risk (>20%), intermediate-risk (5%-20%),and low-risk (<5%).The most frequently involved site was the nasopharynx (35.2%),followed by the maxillary (21.9%) and ethmoid (21.9%) sinuses.Local disease and regional LN spread followed an orderly pattern without LN skipping.The retropharyngeal nodes (RPNs) were most frequently involved (19.0%), followed by level Ⅱ (11.4%).The 5-year overall survival (OS), progression-free survival (PFS), and locoregional control (LRC) rates for all patients were 72.8%, 65.2%, and 90.0%, respectively.The presence of PTI and regional LN involvement based on MRI significantly and negatively affected PFS and OS.Conclusions: Early-stage nasal NKTCL presents with a high incidence of PTI but a relatively low incidence of regional LN spread.Locoregional spread followed an orderly pattern, and PTI and regional LN spread are powerful prognostic factors for poorer survival outcomes.CTV reduction may be feasible for selected patients.
Run-Ye Wu Kang Liu Wei-Hu Wang Jing Jin Yong-Wen Song Shu-Lian Wang Yue-Ping Liu Hua Ren Hui Fang Qing-Feng Liu Yong Yang Bo Chen Shu-Nan Qi Ning-Ning Lu Yu Tang Yuan Tang Ning Li Han Ouyang Ye-Xiong Li
Departments of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medica Departments of Imaging Diagnosis, National Cancer Center/Cancer Hospital, Chinese Academy of Medical
国内会议
北京
英文
344-353
2016-10-01（万方平台首次上网日期，不代表论文的发表时间）