scholarly journals Prognostic Value of Classifying Parapharyngeal Extension in Nasopharyngeal Carcinoma Based on Magnetic Resonance Imaging

2015 ◽  
Vol 2015 ◽  
pp. 1-8
Author(s):  
Guo-Yi Zhang ◽  
Ying Huang ◽  
Xue-Feng Hu ◽  
Xiang-Ping Chen ◽  
Tao Xu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Nasopharyngeal Carcinoma ◽  
Prognostic Value ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Retropharyngeal Space ◽  
Resonance Imaging ◽  
Free Survival ◽  
Masticator Space

Purpose. To subclassify parapharyngeal extension in nasopharyngeal carcinoma (NPC) and investigate its prognostic value and staging categories based on magnetic resonance imaging (MRI).Methods and Materials. Data from 1504 consecutive NPC patients treated with definitive-intent radiotherapy were analyzed retrospectively. Sites of parapharyngeal extension were defined by MRI. Overall survival (OS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were calculated by the Kaplan-Meier method and compared with the log-rank test. Hazard consistency and hazard discrimination were determined by multivariate analysis with Cox proportional hazards models.Results. 1104 patients (73.4%) had parapharyngeal extension; 1.7–63.8% had involvement of various anatomic sites. The hazard ratio for death was significantly higher with extensive parapharyngeal extension (lateral pterygoid muscle of masticator space and beyond or parotid space) than with mild extension (medial pterygoid muscle of masticator space, or carotid, prestyloid, and prevertebral or retropharyngeal space). OS, LRFS, and DMFS with extensive parapharyngeal extension were similar to those in T4 disease; OS, LRFS, and DMFS with mild parapharyngeal extension were significantly higher than in those T3 disease (allP≤ 0.015).Conclusions. Parapharyngeal extension in NPC should be subclassified as mild or extensive, which should be regarded as stages T2 and T4 diseases, respectively.

scholarly journals Early intra-treatment diffusion weighted magnetic resonance imaging in patients with recurrent nasopharyngeal carcinoma treated with nivolumab

2020 ◽  
Vol 6 (3) ◽  
pp. 568
Author(s):  
Tiffany Y. So ◽  
Qi-Yong Ai ◽  
Brigette B.Y. Ma ◽  
Ann D. King
Keyword(s):  
Magnetic Resonance Imaging ◽  
Overall Survival ◽  
Magnetic Resonance ◽  
Nasopharyngeal Carcinoma ◽  
Progression Free Survival ◽  
Tumour Volume ◽  
Resonance Imaging ◽  
Free Survival ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging

<p class="abstract">Immune check point inhibitors have demonstrated promising efficacy in patients with recurrent or metastatic nasopharyngeal carcinoma (NPC) in phase I and phase II trials. Early identification of treatment response is important in these patients. This report aimed to document the early intratreatment diffusion weighted magnetic resonance imaging (DW-MRI) findings in NPC patients following treatment with the programmed cell death-1 inhibitor, nivolumab. Two consecutive patients with histologically confirmed recurrent undifferentiated NPC treated with nivolumab were prospectively recruited. Nivolumab was administered at a dosage of 3 mg/kg intravenously every 2 weeks. Patients underwent magnetic resonance imaging examinations at baseline, and at 3 and 5 weeks after commencement of treatment. Intratreatment changes in tumour volume and apparent diffusion coefficient (ADC<sub>mean</sub>)were calculated. The endpoints were objective response by response evaluation criteria in solid tumors and survival. In patient 1, an intratreatment ADC increase at 5 weeks corresponded with anatomical tumour volume reduction and a better long-term survival outcome (progression free survival 1.3 years, overall survival 2.9 years). In patient 2, an intratreatment ADC decrease at 5 weeks corresponded to progressive disease and worse outcome (progression free survival 0.0 years, overall survival 0.9 years). Intratreatment ADC changes at 3 weeks were not associated with response outcome. These cases suggest that intratreatment changes in ADC at 5 weeks may potentially predict tumour response in patients treated with nivolumab. Dedicated studies are needed to clarify these findings and fully characterise patterns of treatment related ADC change.</p>

Analysis of Prognostic Risk Factors in Patients with Nasopharyngeal Carcinoma Treated with Radiotherapy by Magnetic Resonance Imaging

2020 ◽  
Vol 10 (9) ◽  
pp. 2079-2083
Author(s):  
Jie Qi ◽  
Mang Xiao ◽  
Sharma Vikas
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Survival Rate ◽  
Magnetic Resonance ◽  
Nasopharyngeal Carcinoma ◽  
Resonance Imaging ◽  
Residual Rate ◽  
Free Survival ◽  
N Stage ◽  
Prognostic Risk Factors

The purpose of the study was to explore the application value of magnetic resonance imaging (MRI) technology in the study of the prognosis of patients with nasopharyngeal carcinoma (NPC) after radiotherapy, and to analyze the risk factors leading to imaging residues, so as to provide reference for the treatment and prognosis of patients with NPC. The clinical data of 691 patients with NPC hospitalized from June 2008 to June 2016 were retrospectively analyzed. According to the results of magnetic resonance medical imaging, the residual data of patients with NPC after treatment were analyzed. Combined with t-stage and n-stage parameters, the image residual was divided into t-stage residual and n-stage residual. The radiological residues, residual regression time, survival time, recurrence and metastasis time were recorded. The radiological residual rate of NPC after radiotherapy was calculated, and the differences among groups were compared by chi-square test. The risk factors of image residual and residual regression time were analyzed by logistic regression model. The 5-year overall survival rate (OS), 5-year recurrence-free survival rate (LRFS), and 5-year distant metastasis-free survival rate (DMF) were calculated. Kaplan.Meier method was used to analyze the influence of various factors on the prognosis of patients, and logarithmic rank test was used to compare the difference of survival rate between the two groups. The results showed that the residual rate of T and N was 32.9% and 31.0% at the end of radiotherapy for NPC. In summary, magnetic resonance medical imaging technology can effectively evaluate the prognostic risk factors of patients with NPC after radiotherapy. Male, elderly, radioactivity residue, and high stage are the risk factors affecting the prognosis of patients with NPC after radiotherapy. The recurrence and metastasis of NPC patients can be effectively controlled by means of emphasizing radiotherapy combined with adjuvant chemotherapy.

Prognostic Value of the Albumin-to-Alkaline Phosphatase Ratio before Chemoradiotherapy in Patients with Nonmetastatic Nasopharyngeal Carcinoma

Chemotherapy ◽  
2021 ◽  
pp. 1-7
Author(s):  
Liping Yang ◽  
Jing Gao ◽  
Yan Zhou ◽  
Zhenchao Tao ◽  
Jian He ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Nasopharyngeal Carcinoma ◽  
Prognostic Value ◽  
Proportional Hazards ◽  
Prognostic Index ◽  
Progression Free Survival ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Optimal Cutoff ◽  
Free Survival

Introduction: The aim of this study was to evaluate the prognostic value of the albumin-to-alkaline phosphatase ratio (AAPR) in patients with nonmetastatic nasopharyngeal carcinoma (NPC). Methods: Patients with nonmetastatic NPC who underwent chemoradiotherapy (CRT) were retrospectively analyzed. The AAPR was calculated using the last value of albumin to alkaline phosphatase that was measured within 1 week before CRT. The optimal cutoff value for the AAPR value was determined by an X-tile plot. Propensity score matching (PSM) was performed to balance the differences of the baseline characteristics. The Kaplan-Meier method and log-rank test were used to calculate the survival. A Cox proportional hazards regression model was conducted for the multivariate analysis. Results: Totally, 87 patients with nonmetastatic NPC who underwent CRT were included in the analysis. The optimal cutoff level for the AAPR was 0.46. The group with an AAPR ≤0.46 was more likely to have poorer overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) (p = 0.023, p = 0.031 and p = 0.027, for OS, PFS, and DMFS, respectively). In Cox proportional hazards analysis, high AAPR was a better prognostic predictor. Conclusion: AAPR may be a reliable prognostic index for nonmetastatic NPC patients.

scholarly journals Pre- and Postoperative Parameters on Magnetic Resonance Imaging Predict Continence Recovery after Laparoscopic Radical prostatectomy

2020 ◽  
Author(s):  
Fan Zhang ◽  
Bin Yang ◽  
Ye Yan ◽  
Yichang Hao ◽  
Yi Huang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Radical Prostatectomy ◽  
Proportional Hazards ◽  
Removal Rate ◽  
Cox Proportional Hazards ◽  
Laparoscopic Radical Prostatectomy ◽  
Rank Test ◽  
Resonance Imaging ◽  
Vesicourethral Anastomosis

Abstract Background: To evaluate the association between pre- and postoperative parameters on magnetic resonance imaging (MRI) and continence recovery after laparoscopic radical prostatectomy (LRP). Methods: 73 patients who underwent LRP were retrospectively reviewed. Demographic characteristics, clinicopathologic outcomes and several MRI parameters before and after surgery were evaluated. Continence was defined as no pad per day. Early continence recovery was defined as continence recovery within 3 months. Kaplan-Meier analyses and log-rank test were used to compare time to continence recovery. Cox proportional-hazards regression analyses were performed to identify independent predictors of continence recovery after LRP.Results: Patients with smaller prostatic volume, shorter intravesical prostatic protrusion length (IPPL), longer preoperative membranous urethral length (MUL), lower MUL-removal rate, triangular vesicourethral anastomosis (VUA) and neurovascular bundle sparing experienced a faster continence recovery (All, p < 0.05). Multivariate analyses revealed IPPL (hazard ratio [HR]: 0.94, p = 0.044), preoperative MUL (HR: 1.10, p = 0.032), MUL-removal rate (HR: 0.91, p = 0.007) and shape of VUA (square vs. triangle, HR: 2.30, p = 0.012) were independent predictors of continence recovery after LRP.Conclusion: IPPL, preoperative MUL, MUL-removal rate and shape of VUA were promising parameters on MRI for predicting continence recovery after LRP.

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