Liu Ting, Lv Jun, Qin Yutao
Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China.
Oncotarget. 2017 Aug 17;8(41):70299-70309. doi: 10.18632/oncotarget.20313. eCollection 2017 Sep 19.
The study evaluated the prognostic effect of standardized tumor volume in patients with advanced nasopharyngeal carcinoma (NPC) treated with concurrent chemoradiotherapy. Between Jan 1, 2009 and December 30, 2012, 143 patients diagnosed with NPC in UICC stage III-IVb by histopathology were enrolled in the study. These patients underwent intensity-modulated radiotherapy combined with concurrent chemotherapy. The three-dimensional images of tumor volume were reconstructed automatically by the treatment planning system. SGTVnx was calculated based on GTVnx/person's volume. SGTVnd was calculated based on GTVnd/person's volume. SGTVnx was significantly associated with the 5-year overall survival (OS), disease-free survival (DFS), DMFS, and LRFS rates in univariate and multivariate analyses. Although SGTVnd was associated with the 5-year OS, DFS, and DMFS rates, it was not an independent prognostic factor for LRFS. In receiver operating characteristic (ROC) curve analysis, 1.091 and 0.273 were determined as the cut-off points for SGTVnx and SGTVnd, respectively. The 5-year OS, DFS, DMFS, and LRFS rates for patients with a SGTVnx > 1.091 SGTVnx ≤ 1.091 was 65.4% 93.4% ( 0.001), 65.2% 94.8% ( 0.001), 71.4% 97.4% ( 0.001), and 84.8% 97.3% ( 0.003), respectively, for SGTVnd > 0.273 SGTVnd ≤ 0.273 was 70.3% 96.5% ( 0.001), 70.1% 94.8% ( 0.001), 77.5% 98.2% ( 0.001), and 88.5% 96.6% ( 0.049), respectively. UICC stage grouping, T classification, N classification, and sex were not found to be independent prognostic factors for NPC. Standardized tumor volume was an independent prognostic factor for NPC that might improve the current NPC TNM classification system and provide new clinical evidence for personalized treatment strategies.
本研究评估了同步放化疗治疗的晚期鼻咽癌（NPC）患者中标准化肿瘤体积的预后影响。在2009年1月1日至2012年12月30日期间，143例经组织病理学诊断为UICC III-IVb期NPC的患者纳入本研究。这些患者接受调强放疗联合同步化疗。肿瘤体积的三维图像由治疗计划系统自动重建。基于GTVnx/个体体积计算SGTVnx。基于GTVnd/个体体积计算SGTVnd。在单因素和多因素分析中，SGTVnx与5年总生存（OS）、无病生存（DFS）、远处转移无病生存（DMFS）和局部区域复发无病生存（LRFS）率显著相关。虽然SGTVnd与5年OS、DFS和DMFS率相关，但它不是LRFS的独立预后因素。在受试者工作特征（ROC）曲线分析中，分别确定1.091和0.273为SGTVnx和SGTVnd的截断点。SGTVnx > 1.091与SGTVnx≤1.091患者的5年OS、DFS、DMFS和LRFS率分别为65.4%对93.4%（P<0.001）、65.2%对94.8%（P<0.001）、71.4%对97.4%（P<0.001）和84.8%对97.3%（P<0.003）；SGTVnd > 0.273与SGTVnd≤0.273患者的5年OS、DFS、DMFS和LRFS率分别为70.3%对96.5%（P<0.001）、70.1%对94.8%（P<0.001）、77.5%对98.2%（P<0.001）和88.5%对96.6%（P = 0.049）。未发现UICC分期分组、T分类、N分类和性别是NPC的独立预后因素。标准化肿瘤体积是NPC的独立预后因素，可能会改进当前的NPC TNM分类系统，并为个性化治疗策略提供新的临床证据。
