T classification and clivus margin as risk factors for determining locoregional control by radiotherapy of nasopharyngeal carcinoma

Jian, James Jer-Min; Cheng, Skye Hongiun; Prosnitz, Leonard R.; Tsai, Shih Chang; Tsai, Ming-Jan; Huang, Andrew T.

doi:10.1002/(sici)1097-0142(19980115)82:2<261::aid-cncr3>3.0.co;2-u

Cited by 20 publications

(2 citation statements)

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“…Several earlier studies on nasopharynx and other head and neck regions demonstrated the superiority of MRI delineation in this respect [11,14,25,26]. To make delineation on two modalities easier, double window delineation was introduced into the second phase delineation software.…”

Section: Discussionmentioning

confidence: 99%

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Decreased 3D observer variation with matched CT-MRI, for target delineation in Nasopharynx cancer

et al. 2010

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PurposeTo determine the variation in target delineation of nasopharyngeal carcinoma and the impact of measures to minimize this variation.Materials and methodsFor ten nasopharyngeal cancer patients, ten observers each delineated the Clinical Target Volume (CTV) and the CTV elective. After 3D analysis of the delineated volumes, a second delineation was performed. This implied improved delineation instructions, a combined delineation on CT and co-registered MRI, forced use of sagittal reconstructions, and an on-line anatomical atlas.ResultsBoth for the CTV and the CTV elective delineations, the 3D SD decreased from Phase 1 to Phase 2, from 4.4 to 3.3 mm for the CTV and from 5.9 to 4.9 mm for the elective. There was an increase agreement, where the observers intended to delineate the same structure, from 36 to 64 surface % (p = 0.003) for the CTV and from 17 to 59% (p = 0.004) for the elective. The largest variations were at the caudal border of the delineations but these were smaller when an observer utilized the sagittal window. Hence, the use of sagittal side windows was enforced in the second phase and resulted in a decreased standard deviation for this area from 7.7 to 3.3 mm (p = 0.001) for the CTV and 7.9 to 5.6 mm (p = 0.03) for the CTV elective.DiscussionAttempts to decrease the variation need to be tailored to the specific causes of the variation. Use of delineation instructions multimodality imaging, the use of sagittal windows and an on-line atlas result in a higher agreement on the intended target.

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Section: Discussionmentioning

confidence: 99%

“…The addition of MRI to CT-based delineation has proven its value in the delineation of the Head and Neck region and has resulted in smaller target volumes [2,6,11,14,25,26]. Especially when posterior invasion is suspected, MRI has proven to be superior to CT based staging [26].…”

Section: Introductionmentioning

confidence: 99%

Decreased 3D observer variation with matched CT-MRI, for target delineation in Nasopharynx cancer

et al. 2010

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Nasopharyngeal Carcinoma

O’Sullivan¹,

Chong²

2014

TNM Online

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Nasopharyngeal carcinoma (NPC) is unusual in several ways. Its epidemiology, associated with ethnicity, genetic predisposition, viral, and environmental dietary exposure, is unique in itself. In addition, the predilection for certain geographic areas, with relative sparing of adjacent regions is noteworthy. Unjustly perhaps, NPC poses a formidable public health hazard to countries that are relatively compromised in their ability to provide the technical diagnostic and therapeutic approaches considered to be necessary for optimal management today. However, what sets it apart from most diseases is the anatomic challenge it presents to the oncology team because of the proximity of the nasopharynx to critical anatomic structures and the high predilection for distant metastasis once the primary and regional lymph‐node areas are extensively involved, which is all too frequent. In this chapter we discuss prognostic factors of importance in the management of NPC using the classification proposed earlier in this book. Factors will be considered by whether they relate to the disease itself, the patient (or host ), or the environment which influences the opportunity for optimal treatment and diagnosis. The classification may not always apply since, in the case of NPC, there may be overlap among factors and arbitrary placement of factors may be necessary. We will also attempt to categorize the available evidence into factors which are essential to our ability to treat the disease ( essential factors), those which add valuable information about the disease but do not affect treatment decisions ( additional factors), and finally those that are being described and may provide important understanding of disease behavior and therapeutic approaches in future years. In the interest of relevance to the treatment of the disease, and for brevity, the discussion of the final group of factors (those termed new and promising ), will be restricted to experience of patient outcome. Therefore, preclinical studies will not receive attention. Special attention to the classification of stage of disease will be given. This is because for NPC anatomic features are so important that a relevant and reproducible system of classification merits attention above other prognostic factors. In fact, few diseases received the same level of attention in the preparation of the 5th edition (TNM) stage classification of the International Union Against Cancer (UICC) and the American Joint Committee on Cancer (AJCC). A major revision of the NPC stage was accomplished by a substantial collaborative consultation among radiation oncologists in Southeast Asia, with support from diagnostic radiologists, pathologists, and surgeons there and elsewhere.

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IMRT for Carcinomas of the Nasopharynx

2006

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T classification and clivus margin as risk factors for determining locoregional control by radiotherapy of nasopharyngeal carcinoma

Abstract: The dimension of each tumor as shown on the treatment planning CT were dation Sun Yat-Sen Cancer Center, Taipei, Tai-mapped on conventional simulation films. The extent of each tumor was further wan. affirmed by magnetic resonance imaging (MRI) and the tumor map revised as

Cited by 20 publications

References 17 publications

Decreased 3D observer variation with matched CT-MRI, for target delineation in Nasopharynx cancer

Decreased 3D observer variation with matched CT-MRI, for target delineation in Nasopharynx cancer

Nasopharyngeal Carcinoma

IMRT for Carcinomas of the Nasopharynx

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