咽旁間隙侵犯對鼻咽癌預後之影響

Prognostic Influence of Parapharyngeal Space Extension in Nasopharyngeal Carcinoma

劉耿良(Keng-Lian Liu) ； 朱繡棟(Sau-Tung Chu) ； 侯友益(Yu-Yi Hou) ； 張國平(Kuo-Ping Chang) ； 紀昭全(Chao-Chuan Chi) ； 林明毅(Ming-Yee Lin) ； 劉秀芬(Hsiu-Fen Liu) ； 蘇性豪(Hsing-Hao Su) ； 李清池(Ching-Chih Lee)

《台灣耳鼻喉頭頸外科雜誌》 44卷6期 (2009/12) Pp. 176-182

https://doi.org/10.6286/2009.44.6.176

摘要

BACKGROUND: To access the prognostic value of parapharyngeal space extension in any recurrence and distant metastasis in patients with nasopharyngeal carcinoma (NPC) who were treated with radiotherapy or concurrent chemoradiotherapy.
METHOD: A total of 102 patients with newly diagnosed NPC were enrolled in this study. The parapharyngeal space invasion evaluated by magnetic resonance imaging (MRI) was identified and graded according to Sham and Choy's classification. The overall survival, any recurrence and distant metastasis were analyzed by Kaplan-Meier method and log-rank test to determine the difference of treatment outcome between groups. Cox regression method was also used for multivariate analysis of different independent factors.
RESULT: The incidence of parapharyngeal space extension was high (74.5%). Of these patients, 43.6% had grade 2 or grade 3 extension. The overall survival and distant metastasis-free survival were affected by the presence of parapharyngeal space involvement (p＜0.001, p=0.015, respectively). Multivariate analysis showed that grade 2 and 3 parapharyngeal extension were independent factors in predicting distant metastasis (grade2, p=0.018; grade3, p=0.04). Grade 3 parapharyngeal space extension was another independent factor in predicting any recurrence (p=0.037), whereas advanced N classification (N3) was another independent factor in predicting any recurrence and locoregional recurrence (p=0.014, and 0.011, respectively).
CONSLUSION: Parapharyngeal tumor involvement had significant predictive value. It affected any recurrence and distant metastasis.

關鍵字

咽旁間隙 ； 鼻咽癌 ； 存活率

並列摘要

BACKGROUND: To access the prognostic value of parapharyngeal space extension in any recurrence and distant metastasis in patients with nasopharyngeal carcinoma (NPC) who were treated with radiotherapy or concurrent chemoradiotherapy.
METHOD: A total of 102 patients with newly diagnosed NPC were enrolled in this study. The parapharyngeal space invasion evaluated by magnetic resonance imaging (MRI) was identified and graded according to Sham and Choy's classification. The overall survival, any recurrence and distant metastasis were analyzed by Kaplan-Meier method and log-rank test to determine the difference of treatment outcome between groups. Cox regression method was also used for multivariate analysis of different independent factors.
RESULT: The incidence of parapharyngeal space extension was high (74.5%). Of these patients, 43.6% had grade 2 or grade 3 extension. The overall survival and distant metastasis-free survival were affected by the presence of parapharyngeal space involvement (p＜0.001, p=0.015, respectively). Multivariate analysis showed that grade 2 and 3 parapharyngeal extension were independent factors in predicting distant metastasis (grade2, p=0.018; grade3, p=0.04). Grade 3 parapharyngeal space extension was another independent factor in predicting any recurrence (p=0.037), whereas advanced N classification (N3) was another independent factor in predicting any recurrence and locoregional recurrence (p=0.014, and 0.011, respectively).
CONSLUSION: Parapharyngeal tumor involvement had significant predictive value. It affected any recurrence and distant metastasis.

並列關鍵字

parapharyngeal space ； nasopharyngeal carcinoma NPC ； survival