诱导化疗后局部晚期鼻咽癌靶病灶体积缩小的预后价值。

The prognostic value of volumetric reduction of the target lesions after induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma.

机构信息

Department of Head and Neck Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.

Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.

出版信息

Head Neck. 2019 Jun;41(6):1863-1872. doi: 10.1002/hed.25620. Epub 2019 Jan 8.

DOI:10.1002/hed.25620

PMID:30620441

Abstract

BACKGROUND

We explored whether the volumetric reduction ratio of target lesion after induction chemotherapy (IC) had any prognostic value in nasopharyngeal carcinoma (NPC).

METHODS

From 2013 to 2016, 72 NPC patients treated with PCF (paclitaxel, cisplatin, 5-fluorouracil) IC followed by cisplatin-based concurrent chemoradiotherapy were analyzed. The volumes of target lesions before and after IC and survival conditions were assessed.

RESULTS

For all cases, volumetric reduction ratios of the total tumor load ≥ optimal cutoff values were significantly associated with increased 2-year progression-free survival, locoregional failure-free survival, and distant metastasis-free survival (DMFS) rates, and for cervical lymph nodes, the volumetric reduction ratio ≥ optimal cutoff value was significant for DMFS (all P < .05). Accordingly, the optimal cutoff values were 24.56% (AUC = 60.5%), 23.91% (AUC = 57.7%), 29.77% (AUC = 75.8%), and 34.17% (AUC = 62.5%), respectively.

CONCLUSION

Volumetric reductions of target lesions after IC are independent survival predictors for NPC, especially for those with N2/N3 disease.

摘要

背景

本研究旨在探讨诱导化疗（IC）后目标病灶的体积缩减率（Tumor Volume Reduction Ratio，TVRR）对鼻咽癌（Nasopharyngeal Carcinoma，NPC）患者的预后价值。

方法

回顾性分析了 2013 年至 2016 年期间，72 例接受紫杉醇、顺铂、氟尿嘧啶（PCF）方案诱导化疗后，行顺铂为基础的同期放化疗的 NPC 患者。评估了患者治疗前后的靶病灶体积和生存状况。

结果

在所有患者中，总肿瘤负荷的 TVRR≥最佳截断值与 2 年无进展生存率、无局部区域失败生存率和无远处转移生存率（Distant Metastasis-Free Survival，DMFS）的增加显著相关，对于颈部淋巴结，TVRR≥最佳截断值与 DMFS 显著相关（均 P<.05）。因此，最佳截断值分别为 24.56%（AUC=60.5%）、23.91%（AUC=57.7%）、29.77%（AUC=75.8%）和 34.17%（AUC=62.5%）。