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CT-diagnosed severe skull base bone destruction predicts distant bone metastasis in early N-stage nasopharyngeal carcinoma

Authors Yi W, Liu ZG, Li X, Tang J, Jiang CB, Hu JY, Tu ZW, Wang H, Niu DL, Xia YF

Received 3 November 2015

Accepted for publication 7 August 2016

Published 14 November 2016 Volume 2016:9 Pages 7011—7017


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Manfred Beleut

Peer reviewer comments 4

Editor who approved publication: Professor Min Li

Wei Yi,1,* Zhi-Gang Liu,2,3,* Xian Li,4 Jiao Tang,2,3 Chang-Bin Jiang,1 Jing-Ye Hu,5 Zi-Wei Tu,5 Hui Wang,2,3 Dao-Li Niu,1 Yun-Fei Xia5

1Department of Radiotherapy, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 2Department of Radiotherapy, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 3Key Laboratory of Translational Radiation Oncology, Hunan Province, 4Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, 5State Key Laboratory of Oncology in Southern China, Department of Radiotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China

*These authors contributed equally to this work

Abstract: Bone metastasis is the most frequent type of distant metastasis in nasopharyngeal carcinoma (NPC). In this study, we investigated the correlation between the skull base bone destruction and the distant bone metastasis in patients with NPC. A total of 449 cases with NPC who were diagnosed and had definitive radiotherapy from 2001 to 2006 were enrolled in this study. The skull base bone destruction was diagnosed by computed tomography (CT) in all cases, and 191 patients also underwent magnetic resonance imaging scan. Kaplan–Meier method was adopted to perform the univariate analysis; Cox regression model was used to perform multivariate analysis to determine whether the skull base bone destruction when diagnosed by CT was an independent impact factor of the distant bone metastases. The group with skull base bone destruction had a distant bone metastases rate of 9.0% (14/155), whereas the group without skull base bone destruction had rate of 4.1% (12/294). The multivariate analysis showed that the skull base bone destruction, when diagnosed by CT, was an independent impact factor of the distant bone metastases-free survival in the early N-staging cases, but was not an independent impact factor when diagnosed by MRI. The skull base bone destruction diagnosed by CT in patients with NPC had predictive value for the distant bone metastases, especially for the early N-staging cases.

Keywords: bone metastasis, skull base bone destruction, radiotherapy, nasopharyngeal carcinoma

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