14 results on '"Lee, Ching-Chih"'
Search Results
2. Prognostic stratification of oropharyngeal cancer patients in a betel nut chewing and low HPV area
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Lee, Huai-Pao and Lee, Ching-Chih
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- 2023
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3. Postoperative radiotherapy is associated with improved survival in pT1-2N1 oral and oropharyngeal cancer without adequate neck dissection
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Yang, Ching-Chieh, Kang, Bor-Hwang, Liu, Wen-Shan, Yin, Chun-Hao, and Lee, Ching-Chih
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- 2021
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4. Textbook outcome was associated with better survival in oral cancer surgery in southern Taiwan.
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Chiou, Ling‐Jan and Lee, Ching‐Chih
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MOUTH tumors , *BODY mass index , *RESEARCH funding , *PATIENT readmissions , *HEMOGLOBINS , *TEXTBOOKS , *CANCER patients , *TREATMENT effectiveness , *MULTIVARIATE analysis , *DESCRIPTIVE statistics , *PLASTIC surgery , *LENGTH of stay in hospitals , *ALBUMINS , *CONFIDENCE intervals , *NECK surgery , *OVERALL survival - Abstract
Objective: To explore the impact of textbook outcome (TO) on long‐term survival in oral cancer surgery. Subjects and Methods: In total, 386 patients with tumor resection, neck dissection (ND), and reconstruction between 2011 and 2020 were included. TO was defined as negative margin; adequate ND; no 3‐day emergency room revisit; no 30‐day readmission; and length of stay ≤22 days. Multivariate Cox regression was used to evaluate the impact of TO and 5‐year overall survival (OS). Results: The TO rate was 35%. Younger age, subsite in buccal area, Charlson Comorbidity Index Score of 0, higher body mass index, higher hemoglobin, higher albumin, and unilateral ND were associated with TO. 5‐year OS was 70.5% in overall TO patients and 49.0% in non‐TO patients (HR, 0.47; 95% CI, 0.31–0.70; p < 0.001). Non‐TO was associated with an increased mortality rate (aHR, 1.73; 95% CI, 1.14–2.63) after adjusting other factors and the result remained robust with inverse probability of treatment weighting analysis. The impact of TO on OS was more significant in age <60, advanced stage, and diagnosis year before 2018. Conclusion: Not achieving TO in oral cancer surgery was associated with worse long‐term outcome. TO could be used as a proxy for surgical quality improvement. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Squamous cell carcinoma of the oral cavity in young patients: a matched-pair analysis
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Ho, Hsu-Chueh, Lee, Moon-Sing, Hsiao, Shih-Hsuan, Hwang, Juen-Haur, Hung, Shih-Kai, Chou, Pesus, and Lee, Ching-Chih
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- 2008
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6. Stromal categorization of recurrent oral cancer after salvage surgery is associated with survival rates.
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Chang, Yi-Ming and Lee, Ching-Chih
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ORAL cancer ,SURVIVAL rate ,SURGICAL margin ,TUMOR classification ,RADIOTHERAPY ,DECISION making ,TUMOR-infiltrating immune cells - Abstract
Recurrent oral cancer incurred grave outcome. Tumor microenvironment features, like tumor-infiltrating lymphocytes (TILs) or tumor stromal ratio (TSR) had prognostic significance in various cancers. We aimed to evaluate the impact of stromal categorization which incorporated the stromal TILs and TSR on survival outcomes in recurrent oral cancer. 162 patients who received surgery-based treatment between 2010 and 2020 were recruited. Outcomes were 5-year overall survival (OS) and disease-specific survival (DSS). The impact of stromal categorization of recurrent primary tumor or node on 5-year OS and DSS were assessed with the Kaplan-Meier method. Multivariate analysis was performed, incorporating variables at initial treatment and salvage surgery. Patients were further categorized using a survival decision tree. Mean age was 56.1 (SD, 11.3) years; 153 patients (94.4%) were male; 51 patients (31.5%) had stromal category III. Local recurrence occurred in 94 patients (58%), regional recurrence in 55 (34%), and loco-regional recurrence in 13 (8%). Patients with stromal category III had poorer 5-year OS and DSS. Prior radiotherapy, advanced recurrent stage, positive surgical margin, and stromal category III were independent prognosticators for 5-year OS and DSS. In survival decision tree analysis, patients with prior radiotherapy and stromal category III had the worst outcomes. Stromal categorization is associated with outcomes in recurrent oral cancer. Patients with poor prognosticators, such as stromal categorization III, prior radiation, and advanced stage may require closer follow-up and intensive treatment. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Twist Expression of Nasopharyngeal Carcinoma Predicts Pre-vertebral Space Invasion and Survival Outcome
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Lee, Moon-Sing, Lai, Hung-Chih, Hung, Shi-Kai, Ho, Hsu-Chueh, and Lee, Ching-Chih
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nasopharyngeal carcinoma ,Twist ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,survival ,lcsh:RC254-282 - Abstract
Background: The purpose of this study was to explore Twist expression in nasopharyngeal carcinoma and to investigate the prognostic impact of Twist expression on survival rates in patients with nasopharyngeal carcinoma. Methods: We utilized Western blotting to investigate the expression of Twist, vimentin, and E-cadherin in NPC cell lines. Additionally, a retrospective review of case notes from the Dalin Tzu Chi General Hospital archives was performed. We analyzed the relationship between Twist expression of tissue specimen, TNM staging, and survival rates by using immunohistochemical staining. All nasopharyngeal carcinoma patients were included. We used Pearson's chi-square and Fisher's exact tests to analyze the correlation between Twist expression of tissue specimen and TNM staging and clinical features. Kaplan-Meier survival curves were constructed and survival analysis was completed using Cox proportional hazard models. Receiver operating characteristic (ROC) curve was also examined in order to validate the ability of Twist expression to predict outcomes. Results: A total of 48 patients with newly diagnosed NPC were enrolled in this study. Nineteen patients (40%) in this series were found to have Twist overexpression. Twist overexpression in NPC patients was associated with pre-vertebral space invasion (P = 0.032). Patients with Twist overexpression were found to have a poor overall survival rate compared with others (P = 0.01, respectively), but not metastasis free-survival rate (P = 0.126). There was a trend toward significance between Twist expression and advanced T classification (P = 0.094 respectively). Multivariate analysis showed that Twist overexpression was associated with poor survival rate (hazard ratio 5, 95% confidence interval 1.07-27; P = 0.041). The receiver operating characteristic (ROC) curves for predicting outcomes revealed that Twist expression (area under curve = 0.735) was superior to T classification (area under curve = 0.718) and clinical stage (area under curve = 0.598). Conclusions: Twist may be a useful molecular marker for nasopharyngeal carcinoma and indicator for overall survival. Patients with Twist expression should be treated more aggressively.
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- 2014
8. Sarcopenia results in poor survival rates in oral cavity cancer patients.
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Lin, Sheng‐Chiao, Lin, Yaoh‐Shiang, Kang, Bor‐Hwang, Yin, Chun‐Hao, Chang, Kuo‐Ping, Chi, Chao‐Chuan, Lin, Ming‐Yee, Su, Hsing‐Hao, Chang, Ting‐Shou, She, Yun‐Ying, Liu, Yu‐Hsi, and Lee, Ching‐Chih
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ORAL cancer ,SARCOPENIA ,CANCER patients ,MUSCLE mass ,SQUAMOUS cell carcinoma - Abstract
Objective: This study aimed to determine the impact or survival of low skeletal muscle mass (SMM) among patients with oral squamous cell carcinoma (OSCC) undergoing primary surgery. Design: This study was a retrospective cohort study. Setting: Oral squamous cell carcinoma patients treated at our referral centre from April 2005 to March 2014 were examined. Participants: The cohort comprised 276 patients with OSCC undergoing primary surgery. Main outcome measures: Estimated SMM was measured by calculating the cervical skeletal muscle mass from a CT scan of the head and neck. The 5‐year overall survival (OS) and disease‐specific survival (DSS) were analysed using a multivariable Cox regression model. Results: There were 276 patients with a male‐to‐female ratio of 12:1. A low SMM (<47.5 cm2/m2) was associated with worse survival. After adjustment for other factors, the result remained robust for OS (hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.14‐2.67) and disease‐specific survival (HR 1.67, 95% CI 1.04‐2.67). In the subgroup analysis, worse OS and DSS were particularly noted in male patients (HR = 1.90, 95% CI 1.22‐2.97; HR = 1.91, 95% CI 1.27‐3.19) and in those younger than 60 years of age (HR = 1.91, 95% CI 1.14‐3.22; HR = 2.12, 95% CI 1.23‐3.64) with low SMM. Conclusions: Low SMM was a significant independent factor that was associated with lower survival in patients who have oral cavity cancers and are undergoing primary surgery. Preoperative CT scans of the head and neck could be utilised to evaluate SMM, predict treatment outcomes and facilitate nutrition management. [ABSTRACT FROM AUTHOR]
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- 2020
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9. Differential impact of age on survival in head and neck cancer according to classic Cox regression and decision tree analysis.
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Yang, Ching‐Chieh, Su, Yu‐Chieh, Lin, Yu‐Wei, Huang, Chung‐I, and Lee, Ching‐Chih
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HEAD & neck cancer ,DECISION making ,REGRESSION trees ,HYPOPHARYNGEAL cancer ,DECISION trees ,PROPORTIONAL hazards models ,LARYNGEAL cancer - Abstract
Objectives: To assess the impact of age on the survival of patients with head and neck squamous cell carcinoma (HNSCC) using different statistical methods. Design: A retrospective population‐based study. Setting: Surveillance, Epidemiology, and End Results database. Subjects and methods: A total of 28 639 patients with newly diagnosed HNSCC were enrolled between 1 January 2007 and 31 December 2013. The effect of age on 5‐year disease‐specific survival was calculated using a Kaplan‐Meier method and compared using log‐rank tests. A Cox proportional hazards model was used for a multivariate analysis. A classification and regression tree (CART) analysis that partitioned patients with significantly different Kaplan‐Meier curves was introduced to identify the important cancer‐related parameters influencing survival. Results: Uni‐ and multivariate analyses indicated that patients who were older than 60 years had poorer 5‐year disease‐specific survival regardless of tumour subsite and tumor‐node‐metastasis (TNM) stage. However, the CART analysis determined that age played only a minor role in survival after comparing with other prognosticators. The relative importance of age using the Gini index was as follows: 3.21% for oral cancer, 8.32% for oropharyngeal cancer, 2.56% for hypopharyngeal cancer and 16.51% for laryngeal cancer. Conclusions: Different to traditional statistical methods, the CART analysis which was used to identify homogeneous populations revealed that the impact of age varied for different patient groups according to the presence or absence of other prognosticators. This important information could help to guide our clinical decisions and future researches. [ABSTRACT FROM AUTHOR]
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- 2019
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10. Log margin‐to‐thickness ratio improves disease‐specific survival prediction in oral cancer: A single cancer centre database.
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Huang, Chien‐Yu, Lin, Yaoh‐Shiang, Kang, Bor‐Hwang, Chang, Kuo‐Ping, Chi, Chao‐Chuan, Lin, Ming‐Yee, Su, Hsing‐Hao, Chang, Ting‐Shou, Lee, Huai‐Pao, and Lee, Ching‐Chih
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ORAL cancer ,CANCER treatment ,SQUAMOUS cell carcinoma ,METASTASIS ,RADIOTHERAPY - Abstract
Objective: We examined whether dynamic margin criteria margin‐to‐thickness (MTR) ratio has superior predictive value compared with the resection margin or tumour thickness alone in the survival outcome in oral squamous cell carcinoma (OSCC). Design: This is a retrospective cohort study. Setting: Oral squamous cell carcinoma patients treated in Kaohsiung Veterans General Hospital Cancer Center between January 2006 and December 2013. Participants: A cohort of 302 patients with OSCC who had undergone surgical management. Main Outcomes Measures: Log MTR was calculated for each patient, and survival data were analysed using a multivariable Cox regression model. Discriminative analysis was performed using chi‐square, Akaike information criterion (AIC) and Harrell's C tests. Results: After assessing for discriminative ability, the linear trend of log MTR surpassed those of resection margin and tumour thickness in chi‐square, AIC and Harrell's C tests for the advanced pathologic T (pT) category. A multivariate Cox proportional hazard regression model revealed that log MTR <33% was associated with less favourable 5‐year disease‐specific survival (DSS) (P = 0.006) in the entire oral cancer study cohort. Other significant factors included perineural invasion (P = 0.021), pT category, (P = 0.005), pathologic N category (P < 0.001) and differentiation category (P = 0.022). Conclusions: Log MTR < 33% may be a predictor of less favourable outcome in the DSS of OSCC. Log MTR outperformed both resection margin and tumour thickness alone in terms of discriminative analysis. Our study could help in presurgical planning for high‐risk patients and in aiding the decision‐making process for adjuvant treatment. [ABSTRACT FROM AUTHOR]
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- 2019
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11. The influence of marital status on survival for patients aged 65 years and younger with oral cavity cancer.
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Liao, Pei-Hsun and Lee, Ching-Chih
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DENTAL caries , *ORAL cancer , *MARRIAGE , *CANCER patients , *MARITAL status , *ANTHROPOMETRY , *COMBINED modality therapy , *MOUTH , *MOUTH tumors , *MULTIVARIATE analysis , *NECK surgery , *OPERATIVE otolaryngology , *PROGNOSIS , *RADIOTHERAPY , *SURVIVAL , *TUMOR classification , *PROPORTIONAL hazards models - Abstract
Objective: In Taiwan, the median age of diagnosis for oral cavity cancer is 51 year old, which is about 10 years earlier than that in Western countries. A recent study assessing the effect of marriage on outcomes for elderly oral cavity cancer patients (≥66 years old) showed that marriage was associated with better survival. However, little is known about the prognostic significance of marital status in oral cavity cancer patients aged 65 years and younger.Methods: Data from 2007 to 2014 were collected from the Cancer Registry Dataset of the Kaohsiung Veterans General Hospital. We reviewed the records of all newly diagnosed patients with oral cavity cancer who were aged 65 years and younger and being treated by primary surgery with or without neck dissection or adjuvant therapy. None of the included patients had distant metastasis upon diagnosis. In total, 457 patients were indentified. We used multivariate Cox regression model to evaluate the effect of marriage on disease-specific survival rates after adjusting for demographic variables and treatments.Results: There was no significant difference between the married and unmarried groups in stage at diagnosis or treatment. The 5-year disease-specific survival was 70.9% in the married group and 51.2% in the unmarried group (P=0.001). Multivariate analysis with Cox regression showed that unmarried patients had worse disease-specific survival (unmarried, adjusted hazard ratio [aHR] 1.51, 95% CI: 1.06-2.16). Subgroup analysis among patients stratified by the independent factors in multivariate analysis revealed that being unmarried was associated with a trend of worse survival in most stratified groups.Conclusion: Marriage was associated with better disease-specific survival for oral cavity cancer patients aged 65 years and younger. [ABSTRACT FROM AUTHOR]- Published
- 2018
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12. Comparison of different comorbidity measures for oral cancer patients with surgical intervention: A longitudinal study from a single cancer center.
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Lee, Ching-Chih, Ho, Hsu-Chueh, Su, Yu-Chieh, Chen, Po-Chun, Yu, Chia-Hui, and Yang, Ching-Chieh
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ORAL cancer patients , *ORAL cancer , *CANCER-related mortality , *COMPARATIVE studies , *LONGITUDINAL method , *PROGNOSIS , *HYPERTENSION epidemiology , *COMBINED modality therapy , *DIABETES , *HEAD tumors , *LIVER diseases , *RESEARCH methodology , *MEDICAL cooperation , *MOUTH tumors , *MULTIVARIATE analysis , *NECK tumors , *PEPTIC ulcer , *RADIOTHERAPY , *RESEARCH , *SQUAMOUS cell carcinoma , *SURVIVAL , *TUMOR classification , *COMORBIDITY , *EVALUATION research , *ACQUISITION of data , *DISEASE prevalence , *PROPORTIONAL hazards models , *RETROSPECTIVE studies , *SURGERY - Abstract
Objective: Several comorbid measures have been developed and demonstrated the predictive ability for cancer mortality. We conducted a retrospective study on oral squamous cell carcinoma (OSCC) patients to compare the Charlson comorbidity index score (CCIS) to the Elixhauser comorbidity index score (ECIS).Methods: Newly diagnosed OSCC patients (n=232) post major surgery with or without adjuvant therapy were identified from the cancer registry database between 2006 and 2011. Comorbidities present prior to the cancer diagnosis were obtained and adapted to the CCIS and ECIS. The prevalence of comorbid conditions and the influence on disease-specific survival (DSS) rate were calculated and analyzed by Cox regression model. The discriminatory ability of these two comorbid measures was evaluated by using the adjusted hazard ratio and Akaike information criterion (AIC) in a multivariate regression model. The prediction accuracy was assessed using Harrell's c-statistic.Results: Most of the patients (93.5%) were male with a mean age of 54 ± 11 years and 77 of them (33.1%) had at least one comorbid condition. The ECIS was associated DSS, with an additional 10% increased risk observed for mortality for each increased score (HR, 1.10; 95% confidence interval [CI], 1.03-1.18) after adjusting with pathological risk features. However, the CCIS was not an independent prognostic factor for these patients. The ECIS increased discriminatory ability but the CCIS did not improve discrimination.Conclusions: Comorbid conditions significantly influenced the clinical outcomes of patient with OSCC post major surgery. A higher ECIS was associated with worse disease specific survival indicative of a valuable prognostic indicator. The ECIS may be considered in further clinical trials for a variety of cancers, including head and neck cancers. [ABSTRACT FROM AUTHOR]- Published
- 2016
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13. The impact of time factors on overall survival in patients with nasopharyngeal carcinoma: a population-based study.
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Po-Chun Chen, Wen-Shan Liu, Wei-Lun Huang, Cheng-Jung Wu, Ching-Chieh Yang, Ching-Chih Lee, Chen, Po-Chun, Liu, Wen-Shan, Huang, Wei-Lun, Wu, Cheng-Jung, Yang, Ching-Chieh, and Lee, Ching-Chih
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NASOPHARYNX cancer ,CARCINOMA ,RADIOTHERAPY ,KAPLAN-Meier estimator ,SURVIVAL ,TREATMENT effectiveness ,CANCER patients ,DATABASES ,HEALTH services accessibility ,MEDICAL care ,NASOPHARYNX tumors ,PATIENTS ,TIME ,ACQUISITION of data ,PROPORTIONAL hazards models - Abstract
Background: Nasopharyngeal carcinoma (NPC) is most common in Southeast Asia. The purpose of this study is to investigate the correlation between wait time and length of radiotherapy and overall survival (OS) of NPC patients in Taiwan.Methods: From Taiwan's National Health Insurance Research Database, this nationwide population-based cohort study identified 3605 NPC patients who received radiotherapy between 2008 and 2011. The impact of time factors on NPC survival rates was estimated with Kaplan-Meier survival curves. A multivariable Cox hazards regression model tested the significance of results after adjustment for other covariables.Results: In all, 317 patients had wait times >4 weeks, 1404 patients had longer duration of radiotherapy (i.e., >10 weeks) and 499 died. Patients with wait times > 4 weeks and length of radiotherapy ≤ 10 weeks didn't have significantly inferior survival. Patients with wait times >4 weeks and length of radiotherapy >10 weeks had significantly lower OS than other groups, with an adjusted hazard ratio of 1.7 (95 % CI, 1.10-2.60).Conclusion: Time was a significant prognostic factor for NPC patients who had both >4 weeks wait times and length of radiotherapy >10 weeks. Patients with wait time > 4 weeks and length of radiotherapy ≤ 10 weeks had a trend toward an inferior survival. [ABSTRACT FROM AUTHOR]- Published
- 2016
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14. Primary Tumor Volume of Nasopharyngeal Carcinoma: Significance for Recurrence and Survival.
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Chu, Sau-Tung, Wu, Pi-Hsiung, Hou, Yu-Yi, Chang, Kuo-Ping, Chi, Chao-Chuan, and Lee, Ching-Chih
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NASOPHARYNX cancer ,CANCER relapse ,TUMOR prognosis ,CANCER radiotherapy ,CANCER chemotherapy ,MAGNETIC resonance imaging ,MULTIVARIATE analysis - Abstract
Background: Primary tumor volume (PTV) is known to be a significant prognostic factor in malignant tumor. There have been several studies of nasopharyngeal carcinoma (NPC) relating tumor volume to treatment outcome. Our study was designed to evaluate the effect of PTV on treatment outcomes in NPC treated with radiotherapy (RT)/concurrent chemoradiotherapy (CCRT) or CCRT with adjuvant chemotherapy. Methods: We retrospectively reviewed 100 cases with newly diagnosed NPC who were treated with RT/CCRT or CCRT with adjuvant chemotherapy from 2002 to 2006. Magnetic resonance imaging-derived PTV was calculated using the summation-of-area technique. Kaplan-Meier plots and the log-rank test were used to estimate tumor recurrence (locoregional, distant, or both) and overall survival. Cox proportional hazards regression analysis was used to assess the prognostic impact of PTV. Results: The median PTV was 12.94 mL. PTV remained an independent prognostic factor for distant metastasis (hazard ratio [HR], 1.04; p = 0.03), for any relapse (HR, 1.04; p = 0.02), and for overall survival (HR, 1.09; p < 0.001) in multivariate analysis. In the large tumor volume group (PTV > 15 mL), patients'' metastasis-free survival rates, with and without adjuvant chemotherapy, were 100% and 68.3%, respectively (p = 0.002). Their 3-year recurrence-free survival rates, with and without adjuvant chemotherapy, were 94.1% and 69.6%, respectively (p = 0.006). In the small tumor volume group (PTV £ 15 mL), this phenomenon was not observed. Conclusion: PTV had a close relationship with survival rates and recurrence rates in patients with NPC. The large tumor volume group (PTV > 15 mL) was associated with more recurrence and poor survival rate, and it was suggested that these high-risk patients should benefit from CCRT followed by adjuvant chemotherapy. [Copyright &y& Elsevier]
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- 2008
- Full Text
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