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Radiology. 2014 Oct;273(1):136-43. doi: 10.1148/radiol.14132745. Epub 2014 May 15.

Prognostic value of grading masticator space involvement in nasopharyngeal carcinoma according to MR imaging findings.

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  • 1From the Cancer Center, Cancer Research Institute, Foshan Hospital, Sun Yat-sen University, Foshan 528000, Guangdong, People's Republic of China (G.Y.Z., X.P.C., T.X., J.W., W.H.W., Z.L.H., M.M.Z., S.T.X., Y.J.W.); and Department of Radiation Oncology (Y.H.), Department of VIP Region (X.Y.C.), and Imaging Diagnosis and Interventional Center (L.Z.L.), State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.

Abstract

PURPOSE:

To derive a suitable method for grading masticator space invasion in nasopharyngeal carcinoma on the basis of magnetic resonance (MR) images and to determine its prognostic value in patients undergoing intensity-modulated radiation therapy.

MATERIALS AND METHODS:

After institutional review board approval and informed consent were acquired, 808 patients with nasopharyngeal carcinoma who were treated with definitive intensity-modulated radiation therapy were analyzed retrospectively. The anatomic sites of masticator space involvement were identified with MR imaging. Overall survival, local relapse-free survival, and distant metastasis-free survival were calculated by using the Kaplan-Meier method and were compared by using the log-rank test. Potential prognostic factors were identified by means of multivariate analysis.

RESULTS:

Masticator space involvement was diagnosed in 163 of 808 patients (20.2%). Patients with lateral invasion (involvement of the lateral pterygoid muscle of the masticator space and beyond) had significantly poorer overall survival and distant metastasis-free survival than those with medial invasion (involvement of the medial pterygoid muscle of the masticator space) (P = .035 and P = .026, respectively). Furthermore, their overall survival, local relapse-free survival, and distant metastasis-free survival were significantly poorer compared with patients with stage T2 or T3 disease (all P ≤ .023) but similar to patients with stage T4 disease. The grade of masticator space involvement was an independent prognostic factor for overall survival, local relapse-free survival, and distant metastasis-free survival (all P ≤ .023).

CONCLUSION:

Masticator space involvement in nasopharyngeal carcinoma should be graded as medial (stage T2 disease) or lateral (stage T4 disease). This can facilitate staging of nasopharyngeal carcinoma and may be a suitable prognostic indicator of survival.

© RSNA, 2014.

PMID:
24844470
[PubMed - in process]
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