The new staging system for nasopharyngeal carcinoma based on intensity modulated radiation therapy: Results of a prospective multicentric clinical study


Min Kang, Pingting Zhou, Tingting Wei, Tingting Zhao, Rensheng Wang, Guisheng Li, Haolin Yan, Guosheng Feng, Meilian Liu and Jinxian Zhu

Guangxi Medical University, China Liuzhou Worker Hospital, China First People’s Hospital, China People’s Hospital of Guangxi Zhuang Autonomous Region, China Affiliated Hospital of Guilin Medical University, China Wuzhou Red Cross Hospi

: J Diagn Tech Biomed Anal

Abstract


Purpose: To establish a new clinical staging standard for Naso Pharyngeal Carcinoma (NPC) based on Intensity Modulated Radio- Therapy (IMRT) through a prospective multi-center clinical trial. Experiment Design: 492 NPC patients were selected from six hospitals in Guangxi Zhuang autonomous region, China from January 2006 to December 2009. Kaplan-Meier method was adopted to calculate survival rates. Log-rank test was used to compare survival differences. Results: According to the seventh edition of UICC/AJCC staging system, the difference between T1, T2 and T3 were not statistically significant, suggesting that T1, T2 and T3 could be combined as new T1. Moreover, there were significant differences between each N stage except N3a and N3b, suggesting that N3a and N3b could be combined as new N3. Additionally, the OS curves of stage I, II, III and IV were not significantly different between each other. Therefore, we suggest the new clinical NPC staging standard based on MRI and adaptable to IMRT as T stage (including T1 and T2) and N stage (including N0, N1, N2 and N3). The clinical staging includes I (T1N0M0), II (T1N1-2M0, T2N0M0), III (T2N1-2M0), IVa (TxN3M0) and IVb (TxNxM1). Our new recommended staging system performs better in risk difference and distribution balance. Furthermore, the differences of 5-year curves of LRFS, DMFS and OS were all statistically significant than the seventh edition of UICC/AJCC staging system. Conclusions: Our new recommended staging system is more adaptable to IMRT and can predict the prognosis of NPC patient in a more objective and accurate way.

Biography


Min Kang has completed PhD from Guangxi Medical University, Guangxi, P R China. She is the Associate Professor of Department of Radiation Oncology in the First Affiliated Hospital of Guangxi Medical University. She has published more than 12 papers in reputed journals.

E-Mail: hdimcs@163.com

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