Head & neck · 2025
Magnetic Resonance Imaging and [18F]-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography-Guided Therapy Improves Survival in Upper Aerodigestive Tract NK/T-Cell Lymphoma, Nasal Type: A Prospective Cohort Study.
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Ren Quanguang, Cui Yue, Huang He, Li Xueying, Hong Huangming, Wang Zhao, Fang Xiaojie, Guo Chengcheng, Yao Yuyi, Chen Zegeng, Huang Ying, Li Zhiming, Cai Qingqing, Tian Ying, Wang Hanyu, Lin Xiaoping, Fan Wei, Zheng Lie, Lin Suxia, Guo Ying, Lin Tongyu
Аннотация
BACKGROUND: To investigate the value of pretreatment nasopharyngeal and neck magnetic resonance imaging (NN-MRI) combined with positron emission tomography (PET)/CT-guided therapy for improving survival in upper aerodigestive tract NK/T-cell lymphoma (UADT-NKTL) patients.
METHODS: We performed a prospective cohort study including 171 untreated patients histologically diagnosed with UADT-NKTL, of whom 71 patients received PET/CT combined with NN-MRI and the other 100 patients received PET/CT alone. The clinical stage of every patient was classified according to the Ann Arbor and TNM staging systems. Clinical stage, target volume delineation, and survival were evaluated and compared for PET/CT with and without NN-MRI.
RESULTS: By detecting additional local lesions, NN-MRI upgraded the clinical stages on the basis of the Ann Arbor staging system and TNM staging system compared to the results of PET/CT (9/71, p = 0.011; 11/71, p = 0.019, respectively), which revised the target volume delineation of radiotherapy (9/71) in the PET/CT-MRI group. Compared with those in the PET/CT group, 3-year local recurrence-free survival was prolonged in the PET/CT-MRI group (100% vs. 74.9%; p < 0.001), and 3-year overall survival and progression-free survival were better in the PET/CT-MRI group (84.5% vs. 76.3%, p = 0.04 and 78.3% vs. 67.3%, p = 0.03, respectively).
CONCLUSION: NN-MRI and PET/CT-guided therapy could complementarily assist in optimizing the determination of clinical stage and target delineation, which could improve the prognosis of UADT-NKTL patients.
METHODS: We performed a prospective cohort study including 171 untreated patients histologically diagnosed with UADT-NKTL, of whom 71 patients received PET/CT combined with NN-MRI and the other 100 patients received PET/CT alone. The clinical stage of every patient was classified according to the Ann Arbor and TNM staging systems. Clinical stage, target volume delineation, and survival were evaluated and compared for PET/CT with and without NN-MRI.
RESULTS: By detecting additional local lesions, NN-MRI upgraded the clinical stages on the basis of the Ann Arbor staging system and TNM staging system compared to the results of PET/CT (9/71, p = 0.011; 11/71, p = 0.019, respectively), which revised the target volume delineation of radiotherapy (9/71) in the PET/CT-MRI group. Compared with those in the PET/CT group, 3-year local recurrence-free survival was prolonged in the PET/CT-MRI group (100% vs. 74.9%; p < 0.001), and 3-year overall survival and progression-free survival were better in the PET/CT-MRI group (84.5% vs. 76.3%, p = 0.04 and 78.3% vs. 67.3%, p = 0.03, respectively).
CONCLUSION: NN-MRI and PET/CT-guided therapy could complementarily assist in optimizing the determination of clinical stage and target delineation, which could improve the prognosis of UADT-NKTL patients.