Abstract
Background: We evaluated the prognostic role of gross tumor volumes (GTVs) of primary tumor and positive lymph nodes on overall survival (OS) and progression-free survival (PFS) in locally advanced unresectable sinonasal cancer (SNC) treated with definitive intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Methods: Primary tumor GTV (GTV-T), pathologic neck nodes GTV (GTV-N), and positive retropharyngeal nodes GTV (GTV-RPN) of 34 patients with epithelial nonglandular SNC receiving IMRT with or without chemotherapy were retrospectively measured. The GTV variables were analyzed in relation with OS and PFS. Survival curves were estimated using the Kaplan-Meier method and compared with the log-rank test. We also estimated the crude cumulative incidence of locoregional relapses only. The optimal volume cutoff value was determined using an outcome-oriented method among the observed values. Results: GTV-T was significantly associated with decreased OS (P=0.003) and PFS (P=0.003). Moreover, patients with disease total volumes (GTV) smaller than 149.44 cm³ had better OS and PFS than patients with higher volumes (P<0.0001 for both). Neck nodal metastasis impacted on OS and PFS (P=0.030 and P=0.033, respectively), but GTV-N did not (P=0.961; P=0.958). Retropharyngeal nodes metastasis was not associated with prognosis (OS: P=0.400; PFS: P=0.104). When GTV-RPN was added to GTV-N (GTV-TN), a relation with PFS (P=0.041) and a trend toward significance for OS (P=0.075) were found. Conclusions: Our results show that tumor volume is a powerful predictor of outcome in SNC. This could be useful to identify patients with worse prognosis deserving different treatment strategies.
| Original language | English |
|---|---|
| Journal | Tumori |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2019 |
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Keywords
- chemotherapy
- Gross tumor volume
- IMRT
- prognostic factors
- sinonasal cancer
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Prognostic role of primary tumor, nodal neck, and retropharyngeal GTVs for unresectable sinonasal cancers treated with IMRT and chemotherapy. / Ferella, Letizia; Cavallo, Anna; Miceli, Rosalba; Iacovelli, Nicola Alessandro; Giandini, Tommaso; Pignoli, Emanuele; Calareso, Giuseppina; Bossi, Paolo; Resteghini, Carlo; Gravina, Giovanni Luca; Nicolai, Piero; Castelnuovo, Paolo; Piazza, Cesare; Licitra, Lisa; Fallai, Carlo; Orlandi, Ester.
In: Tumori, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prognostic role of primary tumor, nodal neck, and retropharyngeal GTVs for unresectable sinonasal cancers treated with IMRT and chemotherapy
AU - Ferella, Letizia
AU - Cavallo, Anna
AU - Miceli, Rosalba
AU - Iacovelli, Nicola Alessandro
AU - Giandini, Tommaso
AU - Pignoli, Emanuele
AU - Calareso, Giuseppina
AU - Bossi, Paolo
AU - Resteghini, Carlo
AU - Gravina, Giovanni Luca
AU - Nicolai, Piero
AU - Castelnuovo, Paolo
AU - Piazza, Cesare
AU - Licitra, Lisa
AU - Fallai, Carlo
AU - Orlandi, Ester
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: We evaluated the prognostic role of gross tumor volumes (GTVs) of primary tumor and positive lymph nodes on overall survival (OS) and progression-free survival (PFS) in locally advanced unresectable sinonasal cancer (SNC) treated with definitive intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Methods: Primary tumor GTV (GTV-T), pathologic neck nodes GTV (GTV-N), and positive retropharyngeal nodes GTV (GTV-RPN) of 34 patients with epithelial nonglandular SNC receiving IMRT with or without chemotherapy were retrospectively measured. The GTV variables were analyzed in relation with OS and PFS. Survival curves were estimated using the Kaplan-Meier method and compared with the log-rank test. We also estimated the crude cumulative incidence of locoregional relapses only. The optimal volume cutoff value was determined using an outcome-oriented method among the observed values. Results: GTV-T was significantly associated with decreased OS (P=0.003) and PFS (P=0.003). Moreover, patients with disease total volumes (GTV) smaller than 149.44 cm³ had better OS and PFS than patients with higher volumes (P<0.0001 for both). Neck nodal metastasis impacted on OS and PFS (P=0.030 and P=0.033, respectively), but GTV-N did not (P=0.961; P=0.958). Retropharyngeal nodes metastasis was not associated with prognosis (OS: P=0.400; PFS: P=0.104). When GTV-RPN was added to GTV-N (GTV-TN), a relation with PFS (P=0.041) and a trend toward significance for OS (P=0.075) were found. Conclusions: Our results show that tumor volume is a powerful predictor of outcome in SNC. This could be useful to identify patients with worse prognosis deserving different treatment strategies.
AB - Background: We evaluated the prognostic role of gross tumor volumes (GTVs) of primary tumor and positive lymph nodes on overall survival (OS) and progression-free survival (PFS) in locally advanced unresectable sinonasal cancer (SNC) treated with definitive intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Methods: Primary tumor GTV (GTV-T), pathologic neck nodes GTV (GTV-N), and positive retropharyngeal nodes GTV (GTV-RPN) of 34 patients with epithelial nonglandular SNC receiving IMRT with or without chemotherapy were retrospectively measured. The GTV variables were analyzed in relation with OS and PFS. Survival curves were estimated using the Kaplan-Meier method and compared with the log-rank test. We also estimated the crude cumulative incidence of locoregional relapses only. The optimal volume cutoff value was determined using an outcome-oriented method among the observed values. Results: GTV-T was significantly associated with decreased OS (P=0.003) and PFS (P=0.003). Moreover, patients with disease total volumes (GTV) smaller than 149.44 cm³ had better OS and PFS than patients with higher volumes (P<0.0001 for both). Neck nodal metastasis impacted on OS and PFS (P=0.030 and P=0.033, respectively), but GTV-N did not (P=0.961; P=0.958). Retropharyngeal nodes metastasis was not associated with prognosis (OS: P=0.400; PFS: P=0.104). When GTV-RPN was added to GTV-N (GTV-TN), a relation with PFS (P=0.041) and a trend toward significance for OS (P=0.075) were found. Conclusions: Our results show that tumor volume is a powerful predictor of outcome in SNC. This could be useful to identify patients with worse prognosis deserving different treatment strategies.
KW - chemotherapy
KW - Gross tumor volume
KW - IMRT
KW - prognostic factors
KW - sinonasal cancer
UR - http://www.scopus.com/inward/record.url?scp=85071617401&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85071617401&partnerID=8YFLogxK
U2 - 10.1177/0300891619868006
DO - 10.1177/0300891619868006
M3 - Article
AN - SCOPUS:85071617401
JO - Tumori
JF - Tumori
SN - 0300-8916
ER -