SITES OF SKULL BASE INVASION AS PREDICTORS OF INTRACRANIAL EXTENSION IN NASOPHARYNGEAL CARCINOMA AND ITS IMPACT ON THE TREATMENT OUTCOME

顱底侵犯之部位為鼻咽癌腦內蔓延之預測因子及其對預後之影響

許維中(Wei-Chung Hsu) ； 陳宇嘉(Yu-Chia Chen) ； 丁禮莉(Lai-Lei Ting) ； 鍾娜娜(Na-Na Chung) ； 王博民(Po-Ming Wang) ； 陳斯榮(Szu-Jung Chen)

《放射治療與腫瘤學》 24卷2期 (2017/06) Pp. 85-95

https://doi.org/10.6316/TRO/201724(2)85

摘要

Purpose: To evaluate the influence of skull base abnormality on prognosis and correlation with intracranial invasion in nasopharyngeal carcinoma (NPC) patients. Materials and Methods: Total 812 consecutive patients with histologically confirmed NPC who underwent staging computerized tomography and magnetic resonance imaging for evaluation of primary tumor extension were enrolled in this study. All radiologic images were reviewed and assessed for intracranial extension and skull base invasion. Results: Tumor invasion of the foramen ovale, petrous portion of the temporal bone, clivus and the pterygopalatine fossa associated with intracranial involvement. The number in site of skull base lesions showed significant differences in local failure-free survival. Foramen ovale, petrous portion of the temporal bone and pterygopalatine fossa involvement also showed impact on local failure-free survival. Conclusions: Involvement of the skull base such as foramen ovale, petrous portion of the temporal bone, clivus, and pterygopalatine fossa could be good predictors of intracranial involvement in NPC and all except clivus affected local failure-free survival.

關鍵字

Intracranial involvement ； Magnetic resonance imaging ； Nasopharyngeal carcinoma ； Skull base invasion ； Survival

並列摘要

目的：評估鼻咽癌病人顱底侵犯對預後的影響和與腦內蔓延之相關性。材料與方法：本研究包括連續812位經組織診斷為鼻咽癌，並以電腦斷層及磁振攝影進行原發腫瘤蔓延之評估。所有影像均經重新檢視，評估病人影像的腦內蔓延與顱底侵犯狀況。結果：卵圓孔、顳骨岩部、蝶骨斜坡和翼腭窩之腫瘤侵犯與腦內蔓延相關。顱底侵犯之部位數目多少有明顯不同之無局部復發存活率。卵圓孔、顳骨岩部和翼腭窩之腫瘤侵犯也同時影響無局部復發存活率。結論：包括卵圓孔、顳骨岩部、蝶骨斜坡和翼腭窩的顱底侵犯為鼻咽癌併腦內蔓延之良好預測因子，除了蝶骨斜坡外之其餘三者也會影響無局部復發存活率。

並列關鍵字

腦內蔓延 ； 磁振攝影 ； 鼻咽癌 ； 顱底侵犯 ； 存活率