Clinical Comparison Of Intensity Modulated Radio Therapy In 2008 Stage And UICC2010 Staging System For Nasopharyngeal Carcinoma

Objective: To analysis the clinical and survival data of 345 cases of nasopharyngeal carcinoma(NPC)radiotherapy in patients,compare the rationality of nasopharyngeal carcinoma between Chinese 2008 and union for international cancer control(UICC)2010 staging systems.Which will provide a further references for the revision of nasopharyngeal carcinoma staging system.Methods:From November 2011-2012 year in December,370 patients with newly diagnosed,pathologically comfirmed with NPC were retrospectively analyzed,(345 patients are followed up),all patients were staged with the two staging systems.Kappa value was used to evaluate the agreement.The actuarial rates were estimated using the Kaplan-Meier method and the differences were compared using the log-rank test.Results:(1)The 3-year overall survival,relapse free survival and distant metastasis free survival rates were 81.4%,93.4% and 86.7%,respectively.(2)The clinical,T and N staging Kappa values was 0.659,0.727 and 0.811,respectively(P=0.000).The consistency of clinical and T staging was moderate,and the consistency of N was the best.(3)In two staging systems,the curves of overall survival were similar,differences between the groups were not obvious.There were statistically significant differences of OS among II and IVa,III and IVa,T1 and T4,T2 and T4,T3 and T4,N0 and N3,N1 b and N2,N1 b and N3 in 2008 staging system;II and IVa,II and IVb,III and IVb,T1 and T4,T2 and T4,N0 and N2,N0 and N3 b,N1 and N2,N1 and N3 b in 2010 staging system.There was no significant difference in other periods.(4)The two staging standard clinical stage,T stage and 2008 stage N stage recurrence free survival curves cross each other,the difference was not statistically significant,the 2010 stage N stage recurrence free survival curves relative to separate(P < 0.05),but the difference was statistically significant only between N1 and N3 b.(5)There was rarely significant difference between the two stages of the T staging and the clinical stage of the distant metastasis free survival curve.N staging was a good predictor of distant metastasis(P < 0.05).The 2008 stage of the standard N1 a and N1 b distant metastasis free survival curves were close to each other,there existed significantly statistical differences between N0 and N2,N3,N1 a,N1b and N3;N3a and N3 b cross in the 2010 stage.There was obvious statistical significance between N0 and N2,N0 and N3 a,N0 and N3 b,N1 and N2,N1 and N3 a,N1 and N3 b,there was no statistical difference in the rest of the period.The N1 a and N1 b fusion in the 2008 stage,after the integration of N3 a and N3 b in the 2010 stage,the curves of metastasis free survival of the two stages were separated well,except N0 and N1,N2 and N3,the rest of the period was significant.Conclusions: 1.Chinese 2008 and UICC2010 staging standard N staging consistency best,clinical staging,T staging consistency medium.2.The clinical stage,T stage and N stage can predict the overall survival rate.The N stage can predict the survival rate without metastasis,but there is no significant difference between the two groups.3.The clinical stageT staging was less affected for local-free survival rates;The clinical stage and T stage have little influence on the survival rate of distant metastasis.4.In intensity-modulated radiotherapy(IMRI),the results of the two staging criteria were similar for nasopharyngeal carcinoma.