基于调强放射治疗和国际公认的颈部淋巴结分区标准的鼻咽癌新n分期的.研究

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1、08级硕士学位论文基于调强放射治疗和国际公认的颈部淋巴结分区标准的鼻咽癌新N分期的研究discrimination,hazardconsistency,balanceddistribution，andoutcomeprediction．Results：Thenumberofcases埘thnodesdetectedbyMRlwas399／512(77．9％)．Ofthe399patients，retropharyngealregion(80．5％，321／399)andlevelIIb(62．4％，249／

2、399)werethemostfrequentlyinvolvedregions．ThenextmostfrequentlyinvolvedregionsincludedlevelIIa(46．9％，187／399)，levelIlI(19．5％，78／399)，levelV(7％，28／399)，levelIV(4．5％，18／399)，levelIb(3％，12／399)andSCF(1．5％，6／399)．Nolymphnodemetastasiswasfoundinlevella,VIorretro

3、styloidspace．Univariateanalysisof318caseswithpositivecervicallymphnode(CLN)revealedthatlevelandsizeweresignificantfactorsfordistantfailureanddiseasefailure．AccordingtotheHRvaluescalculated，theoptimalcategorizationcriteriatodetermineCLNlevelwastoconsiderlev

4、elsIb,II，IIIandVaslevel1，andlevelIVandSCFaslevel2．Forsize，avalueof1shouldrepresentamaximumcross-sectionaldimension(MCD)S4cm，whileavalueof2shouldindicateaMCD>4cm．Retropharyngeallymphnode(RLN)status，CLNlevel，andlatemlitywereevaluatedasindependentprognosticat

5、orsfordistantfailureanddiseasefailureinmultivariateanalyses．ThesubsetsthatmadeupanNstagegrouphadsimilarHRsfordistantfailure．ThecriteriaofNstagewererevisedasfollows：NO，noregionallymphnodemetastasis；NI，unilaterallevel1involvement，and／orRLNinvolvement；N2，bila

6、terallevel1involvement；andN3，level2involvement．Compared“ththe7theditionoftheUICC／AJCCstagingsystem，theproposedNstageshowedbetterhazarddiscriminationandWasassociated、析thsignificantdiffereficesinHRsofsurvivalfordifferentsubsets．However'thedistributionpattemo

7、ftheproposedNstageWasalittlemoreskewedduetoasmallerpercentageofN3disease(3．9％，20／512)．Conclusions：TheproposedNstagingsystemusingallMRI-determinednodalvariablesandintemationaloonsensusguidelinesforlymphnodelevelsispracticalforIMRTandprovidesahighlyobjective

8、andpredictivemethodforstagingNPCs．Keywords：Nasopharyngealcarcinoma,NStagingSystem，MRI，IMRT,Internationalcx)nsensusguidelinesforlymphnodelevelsIV原创性声明本文郑重声明：所呈交的学位论文，是本人在导师的指导下，独立进行研究工作所取得的成果。除文中已经注明引用的内容外，本论文