{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T11:21:11Z","timestamp":1770463271101,"version":"3.49.0"},"reference-count":33,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thegreenjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Radiotherapy and Oncology"],"published-print":{"date-parts":[[2023,12]]},"DOI":"10.1016\/j.radonc.2023.109939","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T11:26:49Z","timestamp":1696591609000},"page":"109939","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":7,"special_numbering":"C","title":["Prognostic value of metastatic cervical lymph node stiffness in nasopharyngeal carcinoma: A prospective cohort study"],"prefix":"10.1016","volume":"189","author":[{"given":"Xue-Song","family":"Sun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian-Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ru-Hai","family":"Zou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen-Chong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan-Shan","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Ting","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiu-Yan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin-Quan","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3371-634X","authenticated-orcid":false,"given":"Hai-Qiang","family":"Mai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.radonc.2023.109939_b0005","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S0140-6736(19)30956-0","article-title":"Nasopharyngeal carcinoma","volume":"394","author":"Chen","year":"2019","journal-title":"Lancet"},{"key":"10.1016\/j.radonc.2023.109939_b0010","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1016\/S0140-6736(15)00055-0","article-title":"Nasopharyngeal carcinoma","volume":"387","author":"Chua","year":"2016","journal-title":"Lancet"},{"key":"10.1016\/j.radonc.2023.109939_b0015","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1200\/JCO.20.03237","article-title":"Chemotherapy in combination with radiotherapy for definitive-intent treatment of stage II-IVA nasopharyngeal carcinoma: CSCO and ASCO guideline","volume":"39","author":"Chen","year":"2021","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.radonc.2023.109939_b0020","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.ijrobp.2019.06.2549","article-title":"The association between the development of radiation therapy, image technology, and chemotherapy, and the survival of patients with nasopharyngeal carcinoma: a cohort study from 1990 to 2012","volume":"105","author":"Sun","year":"2019","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2023.109939_b0025","doi-asserted-by":"crossref","DOI":"10.1093\/jnci\/djv291","article-title":"Establishment and validation of prognostic nomograms for endemic nasopharyngeal carcinoma","volume":"108","author":"Tang","year":"2016","journal-title":"J Natl Cancer Inst"},{"key":"10.1016\/j.radonc.2023.109939_b0030","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1038\/s41556-018-0236-7","article-title":"Tumour heterogeneity and metastasis at single-cell resolution","volume":"20","author":"Lawson","year":"2018","journal-title":"Nat Cell Biol"},{"key":"10.1016\/j.radonc.2023.109939_b0035","doi-asserted-by":"crossref","first-page":"4557","DOI":"10.1158\/0008-5472.CAN-18-3962","article-title":"The tumor microenvironment innately modulates cancer progression","volume":"79","author":"Hinshaw","year":"2019","journal-title":"Cancer Res"},{"key":"10.1016\/j.radonc.2023.109939_b0040","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.cell.2009.10.027","article-title":"Matrix crosslinking forces tumor progression by enhancing integrin signaling","volume":"139","author":"Levental","year":"2009","journal-title":"Cell"},{"key":"10.1016\/j.radonc.2023.109939_b0045","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1080\/02656736.2021.1947529","article-title":"Prognostic value of liver stiffness measurement in patients with hepatocellular carcinoma (HCC) treated by radiofrequency ablation: a meta-analysis","volume":"38","author":"Zhang","year":"2021","journal-title":"Int J Hyperth"},{"key":"10.1016\/j.radonc.2023.109939_b0050","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s10549-018-4836-5","article-title":"Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival","volume":"171","author":"Evans","year":"2018","journal-title":"Breast Cancer Res Treat"},{"key":"10.1016\/j.radonc.2023.109939_b0055","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s40644-021-00420-8","article-title":"Tumor stiffness measured by 3D magnetic resonance elastography can help predict the aggressiveness of endometrial carcinoma: preliminary findings","volume":"21","author":"Zhang","year":"2021","journal-title":"Cancer Imaging"},{"key":"10.1016\/j.radonc.2023.109939_b0060","unstructured":"Ko KH, Jung HK, Yoon JH, Kim HR. Clinical Application of Shear Wave Elastography (SWE) in the Differential Diagnosis of Small (\u22642cm) Breast LesionsRadiological Society of North America 2013 Scientific Assembly and Annual Meeting; 2013."},{"key":"10.1016\/j.radonc.2023.109939_b0065","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/s40644-020-00362-7","article-title":"Tumor stiffness measured by shear wave elastography correlates with tumor hypoxia as well as histologic biomarkers in breast cancer","volume":"20","author":"Yoo","year":"2020","journal-title":"Cancer Imaging"},{"key":"10.1016\/j.radonc.2023.109939_b0070","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s12070-018-1306-7","article-title":"Is Acoustic Radiation Force Impulse (ARFI) ultrasound elastography valuable in the assessment of cervical lymphadenopathy?","volume":"70","author":"Vinayagamani","year":"2018","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"key":"10.1016\/j.radonc.2023.109939_b0075","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1177\/000348940010901209","article-title":"Comparison of 18-fluoro-2-deoxyglucose positron emission tomography and computed tomography in detection of cervical lymph node metastases of nasopharyngeal carcinoma","volume":"109","author":"Kao","year":"2000","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"10.1016\/j.radonc.2023.109939_b0080","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1148\/radiol.15141251","article-title":"Prognostic value of cervical nodal necrosis in nasopharyngeal carcinoma: analysis of 1800 patients with positive cervical nodal metastasis at MR imaging","volume":"276","author":"Lan","year":"2015","journal-title":"Radiology"},{"key":"10.1016\/j.radonc.2023.109939_b0085","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.radonc.2017.10.032","article-title":"International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma","volume":"126","author":"Lee","year":"2018","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2023.109939_b0090","first-page":"1132","article-title":"Impact of changing gross tumor volume delineation of intensity-modulated radiotherapy on the dose distribution and clinical treatment outcome after induction chemotherapy for the primary locoregionally advanced nasopharyngeal carcinoma","volume":"28","author":"Yu","year":"2009","journal-title":"Ai Zheng"},{"key":"10.1016\/j.radonc.2023.109939_b0095","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1002\/sim.7977","article-title":"Multiple mediation analysis with survival outcomes: with an application to explore racial disparity in breast cancer survival","volume":"38","author":"Yu","year":"2019","journal-title":"Stat Med"},{"key":"10.1016\/j.radonc.2023.109939_b0100","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1111\/jgh.15243","article-title":"Impact of liver-stiffness measurement on hepatocellular carcinoma development in chronic hepatitis C patients treated with direct-acting antivirals: a systematic review and time-to-event meta-analysis","volume":"36","author":"You","year":"2021","journal-title":"J Gastroenterol Hepatol"},{"key":"10.1016\/j.radonc.2023.109939_b0105","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.jhep.2018.10.022","article-title":"Role of liver and spleen stiffness in predicting the recurrence of hepatocellular carcinoma after resection","volume":"70","author":"Marasco","year":"2019","journal-title":"J Hepatol"},{"key":"10.1016\/j.radonc.2023.109939_b0110","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1002\/hep.24108","article-title":"Matrix stiffness modulates proliferation, chemotherapeutic response, and dormancy in hepatocellular carcinoma cells","volume":"53","author":"Schrader","year":"2011","journal-title":"Hepatology"},{"key":"10.1016\/j.radonc.2023.109939_b0115","doi-asserted-by":"crossref","first-page":"e352","DOI":"10.1038\/oncsis.2017.54","article-title":"Matrix stiffness induces epithelial-mesenchymal transition and promotes chemoresistance in pancreatic cancer cells","volume":"6","author":"Rice","year":"2017","journal-title":"Oncogenesis"},{"key":"10.1016\/j.radonc.2023.109939_b0120","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1189\/jlb.1107762","article-title":"Macrophages define the invasive microenvironment in breast cancer","volume":"84","author":"Pollard","year":"2008","journal-title":"J Leukoc Biol"},{"key":"10.1016\/j.radonc.2023.109939_b0125","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1007\/s00330-011-2340-y","article-title":"Shear wave elastography for breast masses is highly reproducible","volume":"22","author":"Cosgrove","year":"2012","journal-title":"Eur Radiol"},{"key":"10.1016\/j.radonc.2023.109939_b0130","doi-asserted-by":"crossref","first-page":"5749","DOI":"10.1016\/j.biomaterials.2014.03.058","article-title":"Sorafenib resistance and JNK signaling in carcinoma during extracellular matrix stiffening","volume":"35","author":"Nguyen","year":"2014","journal-title":"Biomaterials"},{"key":"10.1016\/j.radonc.2023.109939_b0135","doi-asserted-by":"crossref","first-page":"3941","DOI":"10.1038\/s41467-019-11853-y","article-title":"Liquid biopsy tracking during sequential chemo-radiotherapy identifies distinct prognostic phenotypes in nasopharyngeal carcinoma","volume":"10","author":"Lv","year":"2019","journal-title":"Nat Commun"},{"key":"10.1016\/j.radonc.2023.109939_b0140","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1093\/jnci\/94.21.1614","article-title":"Plasma Epstein-Barr virus DNA and residual disease after radiotherapy for undifferentiated nasopharyngeal carcinoma","volume":"94","author":"Chan","year":"2002","journal-title":"J Natl Cancer Inst"},{"key":"10.1016\/j.radonc.2023.109939_b0145","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1056\/NEJMoa032260","article-title":"Quantification of plasma Epstein-Barr virus DNA in patients with advanced nasopharyngeal carcinoma","volume":"350","author":"Lin","year":"2004","journal-title":"N Engl J Med"},{"key":"10.1016\/j.radonc.2023.109939_b0150","doi-asserted-by":"crossref","first-page":"300","DOI":"10.14366\/usg.17024","article-title":"Shear-wave elastography in breast ultrasonography: the state of the art","volume":"36","author":"Youk","year":"2017","journal-title":"Ultrasonography"},{"key":"10.1016\/j.radonc.2023.109939_b0155","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1038\/bjc.2012.253","article-title":"Differentiating benign from malignant solid breast masses: value of shear wave elastography according to lesion stiffness combined with greyscale ultrasound according to BI-RADS classification","volume":"107","author":"Evans","year":"2012","journal-title":"Br J Cancer"},{"key":"10.1016\/j.radonc.2023.109939_b0160","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1038\/s41591-022-02160-z","article-title":"The next generation of evidence-based medicine","volume":"29","author":"Subbiah","year":"2023","journal-title":"Nat Med"},{"key":"10.1016\/j.radonc.2023.109939_b0165","doi-asserted-by":"crossref","first-page":"1776","DOI":"10.1001\/jamaoncol.2022.4656","article-title":"Adjuvant capecitabine following concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: a randomized clinical trial","volume":"8","author":"Miao","year":"2022","journal-title":"JAMA Oncol"}],"container-title":["Radiotherapy and Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0167814023898334?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0167814023898334?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T05:27:23Z","timestamp":1759123643000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0167814023898334"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":33,"alternative-id":["S0167814023898334"],"URL":"https:\/\/doi.org\/10.1016\/j.radonc.2023.109939","relation":{},"ISSN":["0167-8140"],"issn-type":[{"value":"0167-8140","type":"print"}],"subject":[],"published":{"date-parts":[[2023,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Prognostic value of metastatic cervical lymph node stiffness in nasopharyngeal carcinoma: A prospective cohort study","name":"articletitle","label":"Article Title"},{"value":"Radiotherapy and Oncology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.radonc.2023.109939","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"109939"}}