Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
Radiother Oncol. 2012 Sep;104(3):294-9. doi: 10.1016/j.radonc.2012.09.001. Epub 2012 Sep 19.
To evaluate the prognostic value of gross primary tumor volume (GTV-P) in nasopharyngeal carcinoma (NPC) patients treated with intensity modulated radiotherapy (IMRT).
A total of 694 nonmetastatic and histologically proven NPC patients who underwent IMRT were retrospectively reviewed. Samples were split randomly into a training set (n=232) and a test set (n=462) to analysis. The receiver operating characteristic (ROC) curves were calculated to identify the cut-off point and test the prognostic validity of the GTV-P. The correlations between GTV-P and the American Joint Committee on Cancer (AJCC) disease stages were also analyzed.
The 5-year disease-free survival (DFS), overall survival (OS), local relapse-free survival (LRFS) and distant metastasis-free survival (DMFS) rates for NPC patients with GTV-P<19 vs. ≥19 ml were 94.9% vs. 64.8%, 97.0% vs. 76.4%, 98.2% vs. 92.5% and 97.1% vs. 75.2%, respectively (all P<0.05) in all patients. Multivariate analysis indicated GTV-P was an independent prognostic factor. The ROC curve verified that the predictive ability of T classifications was improved when combined with GTV-P (P<0.001).
GTV-P is an independent prognostic indicator for treatment outcome after IMRT, and significantly improves the prognostic validity of T classifications in NPC.
评估调强放疗（IMRT）治疗的鼻咽癌（NPC）患者大体肿瘤体积（GTV-P）的预后价值。
回顾性分析了 694 例经 IMRT 治疗的非转移性和组织学证实的 NPC 患者。将样本随机分为训练集（n=232）和测试集（n=462）进行分析。计算受试者工作特征（ROC）曲线以确定截止点并测试 GTV-P 的预后有效性。还分析了 GTV-P 与美国癌症联合委员会（AJCC）疾病分期之间的相关性。
GTV-P<19ml 和 GTV-P≥19ml 的 NPC 患者的 5 年无疾病生存率（DFS）、总生存率（OS）、局部无复发生存率（LRFS）和远处无转移生存率（DMFS）分别为 94.9%vs.64.8%、97.0%vs.76.4%、98.2%vs.92.5%和 97.1%vs.75.2%（均 P<0.05）。多因素分析表明 GTV-P 是独立的预后因素。ROC 曲线验证了当与 GTV-P 结合时，T 分类的预测能力得到了改善（P<0.001）。
GTV-P 是 IMRT 后治疗结果的独立预后指标，可显著提高 NPC 中 T 分类的预后有效性。
