耳鼻咽喉科・頭頸部外科89巻13号

2017年12月発行

特集 どこが変わった頭頸部がんTNM分類 《各論》

上咽頭がん

著者： 古平毅¹ 牧田智誉子¹

所属機関： ¹愛知県がんセンター中央病院放射線治療部

ページ範囲：P.1074 - P.1079

POINT

●T因子：側頭下窩の定義が変更された。T2に内外翼突筋浸潤，椎前筋浸潤が，T3に頸椎，翼状構造の骨浸潤が追加された。T4に耳下腺浸潤が追加となり，外側翼突筋の外側進展が定義された。

●N因子：N3a，N3bがN3に統一された。輪状軟骨尾側の下方進展がN3に定義された。

●病期（Stage）分類：旧ⅣAと旧ⅣBが新ⅣAとなり，旧ⅣCは新ⅣBとなった。

●解剖学的進展以外の予後因子の表が新設された。

参考文献

1）Lee AW, et al：The strength/weakness of the AJCC/UICC staging system（7th edition）for nasopharyngeal cancer and suggestions for future improvement. Oral Oncol 48：1007-1013, 2012

2）Li WF, et al：Proposed lymph node staging system using the International Consensus Guidelines for lymph node levels is predictive for nasopharyngeal carcinoma patients from endemic areas treated with intensity modulated radiation therapy. Int J Radiat Oncol Biol Phys 86：249-256, 2013

3）OuYang PY, et al：Comparison of TNM staging systems for nasopharyngeal carcinoma, and proposal of a new staging system. Br J Cancer 109：2987-2997, 2013

4）Pan J, et al：A comparison between the Chinese 2008 and the 7th edition AJCC staging systems for nasopharyngeal carcinoma. Am J Clin Oncol 38：189-196, 2015

5）Zhou GQ, et al：Prognostic value of prevertebral space involvement in nasopharyngeal carcinoma based on intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 82：1090-1097, 2012

6）Pan JJ, et al：Proposal for the 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy. Cancer 122：546-558, 2016

7）Gregoire V, et al：Delineation of the neck node levels for head and neck tumors：a 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines. Radiother Oncol 110：172-181, 2014

8）Gregoire V, et al：CT-based delineation of lymph node levels and related CTVs in the node-negative neck：DAHANCA, EORTC, GORTEC, NCIC, RTOG consensus guidelines. Radiother Oncol 69：227-236, 2003

9）Kodaira T, et al：Aichi cancer center initial experience of intensity modulated radiation therapy for nasopharyngeal cancer using helical tomotherapy. Int J Radiat Oncol Biol Phys 73：1129-1134, 2009

10）Nishimura Y, et al：A two-step intensity-modulated radiation therapy method for nasopharyngeal cancer：the Kinki University experience. Jpn J Clin Oncol 40：130-138, 2010

11）Marta GN, et al：Intensity-modulated radiation therapy for head and neck cancer：systematic review and meta-analysis. Radiother Oncol 110：9-15, 2014

12）Blanchard P, et al：Chemotherapy and radiotherapy in nasopharyngeal carcinoma：an update of the MAC-NPC meta-analysis. Lancet Oncol 16：645-655, 2015

13）Zhang J, et al：Epstein-Barr virus DNA level as a novel prognostic factor in nasopharyngeal carcinoma：A meta-analysis. Medicine（Baltimore） 95：e5130, 2016

14）Ribassin-Majed L, et al：What is the best treatment of locally advanced nasopharyngeal carcinoma? An individual patient data network meta-analysis. J Clin Oncol in press, 2016

15）Yan M, et al：Chemoradiotherapy regimens for locoregionally advanced nasopharyngeal carcinoma：A Bayesian network meta-analysis. Eur J Cancer 51：1570-1579, 2015