Yang Chunli,Wu Weili,Jin Feng,et al.A prospective clinical study with long-term follow-up of the correlation between dynamic contrast-enhanced magnetic resonance parameters and prognosis in patients with locally advanced nasopharyngeal carcinoma[J].Chinese Journal of Radiological Medicine and Protection,2020,40(6):446-453 |
A prospective clinical study with long-term follow-up of the correlation between dynamic contrast-enhanced magnetic resonance parameters and prognosis in patients with locally advanced nasopharyngeal carcinoma |
Received:June 18, 2019 |
DOI:10.3760/cma.j.issn.0254-5098.2020.06.006 |
KeyWords:Dynamic contrast-enhanced magnetic resonance imaging Nasopharyngeal carcinoma Efficacy evaluation Prognostic factor |
FundProject:贵州省科技计划项目(LG[2012041]) |
Author Name | Affiliation | E-mail | Yang Chunli | Department of Oncology, Guizhou Cancer Hospital, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China | | Wu Weili | Department of Oncology, Guizhou Cancer Hospital, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China | wwlmhy@163.com | Jin Feng | Department of Oncology, Guizhou Cancer Hospital, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China | | Li Yuanyuan | Department of Oncology, Guizhou Cancer Hospital, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China | | Long Jinhua | Department of Oncology, Guizhou Cancer Hospital, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China | | Luo Xiuling | Department of Oncology, Guizhou Cancer Hospital, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China | | Chen Yu | Department of Oncology, Guizhou Cancer Hospital, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China | | Tang Hong | Department of Oncology, Guizhou Cancer Hospital, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China | | Zhang Mang | Department of Oncology, Guizhou Cancer Hospital, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China | | Weng Kegui | Chongqing Cancer Hospital, Chongqing 400030, China | |
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Abstract:: |
Objective To explore the relationship between semi-quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and long-term prognosis of locally advanced nasopharyngeal carcinoma, and to find prognostic indicators from non-invasive images of locally advanced nasopharyngeal carcinoma. Methods Data were collected from January 2011 to January 2012 via a prospective clinical trial with locally advanced nasopharyngeal carcinoma. Clinical information was from 71 patients who completed the treatment plan with long-term follow-ups and UICC 2010 stage Ⅲ, Ⅳ\-A,Ⅳ\-B. The patients received three cycles of Taxotere-Platinol-Fluorouracil (TPF) regimen chrono-chemotherapy, followed by two cycles of concurrent paclitaxel chemotherapy with intensity-modulated radiotherapy (IMRT). DCE-MRI examination was performed before induction chemotherapy to obtain DCE-MRI related semi-quantitative parameters. Correlation analysis was conducted between DCE-MRI related semi-quantitative parameters and short-term efficacy of nasopharyngeal lesions after concurrent radiotherapy and chemotherapy. Results Of all 77 patients, 71 completed treatment and were followed up from 9 to 86 months, with a median follow-up of 77 months, with 80.2% and 67.6% in 3- and 5-year OS, 73.2% and 60.5% in 3- and 5-year PFS, respectively. Evaluation of short-term efficacy of nasopharyngeal lesions after concurrent chemoradiotherapy:the difference in tissue arrival time of contrast agent between complete response (CR) group and partial response (PR) group was statistically significant (t=0.537, P<0.05). Univariate survival analysis found that OS (χ2=3.982,P<0.05) and PFS (χ2=4.019,P<0.05) in the group with short contrast arrival time were significantly higher than those in the group with long contrast arrival time. OS (χ2=7.593,P<0.05) and PFS (χ2=5.624,P<0.05) of patients aged over 45 years were significantly lower than those aged less than 45 years. Cox multivariate regression model showed that advanced clinical stage (stage Ⅳ\-A, Ⅳ\-B) (P=0.048) and age ≥ 45 years (P=0.031) were independent prognostic factors of OS in patients with nasopharyngeal carcinoma. Long arrival time of contrast agent (P=0.018), age ≥ 45 years (P=0.004), advanced N(2-3) stage (P=0.032) and enhancement peak<3 000 (P=0.005) were independent prognostic factors of PFS in patients with nasopharyngeal carcinoma. Conclusions The arrival time of the contrast agent in DCE-MRI may be a reliable prognostic factor for locally advanced nasopharyngeal carcinoma. |
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