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同步放化疗后局部晚期鼻咽癌远处转移的预后模型

Prognostic model for distant metastasis in locally advanced nasopharyngeal carcinoma after concurrent chemoradiotherapy.

作者信息

Chen Chuangzhen, Chen Siqia, Le Quynh-Thu, Chen Jianzhou, Chen Zhijian, Li Dongsheng, Zhou Mingzhen, Li Derui

机构信息

Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China.

出版信息

Head Neck. 2015 Feb;37(2):209-14. doi: 10.1002/hed.23583. Epub 2014 Mar 25.

Abstract

BACKGROUND

A prognostic model should be established for distant metastasis in locally advanced nasopharyngeal carcinoma (NPC) after concurrent chemoradiotherapy (CCRT).

METHODS

Patients with locally advanced NPC who received CCRT were divided into a construction set (230 patients) and a validating set (115 patients). The constructed index was derived on the former and then tested on the latter.

RESULTS

The prognostic score was defined as the number of adverse prognostic factors: age >45, N3 category, hemoglobin <11.0 g/dL and lactate dehydrogenase ≥240 U/L. The score predicted the 5-year distant metastasis-free survival as follows: 0, 91%; 1, 74%; 2, 51%; and ≥3, 12%. In the validating set, the observed 5-year distant metastasis-free survival of these 4 groups with scores of 0, 1, 2, 3, or higher were 81%, 68%, 47%, and 15%, respectively.

CONCLUSION

The established model might be useful for predicting the risk of distant metastasis in patients with locally advanced NPC who underwent CCRT and may identify the patients' need for intensified adjuvant chemotherapy.

摘要

背景

应建立一个预测模型,用于预测局部晚期鼻咽癌(NPC)同步放化疗(CCRT)后远处转移的情况。

方法

将接受CCRT的局部晚期NPC患者分为构建组(230例患者)和验证组(115例患者)。构建的指标在前一组中得出,然后在后者中进行测试。

结果

预后评分定义为不良预后因素的数量:年龄>45岁、N3分期、血红蛋白<11.0 g/dL和乳酸脱氢酶≥240 U/L。该评分预测5年无远处转移生存率如下:0分,91%;1分,74%;2分,51%;≥3分,12%。在验证组中,这4组评分分别为0、1、2、3及以上的患者观察到的5年无远处转移生存率分别为81%、68%、47%和15%。

结论

所建立的模型可能有助于预测接受CCRT的局部晚期NPC患者远处转移的风险,并可确定患者是否需要强化辅助化疗。

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