基于诱导化疗后肿瘤反应的列线图可预测局部晚期鼻咽癌的生存情况。
A nomogram based on tumor response to induction chemotherapy may predict survival in locoregionally advanced nasopharyngeal carcinoma.
机构信息
Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China.
Key Laboratory of Early Prevention and Treatment for Regional High-Incidence-Tumor, Guangxi Medical University, Ministry of Education, Nanning, Guangxi, China.
出版信息
Head Neck. 2022 Jun;44(6):1301-1312. doi: 10.1002/hed.27020. Epub 2022 Feb 25.
BACKGROUND
To evaluate the clinical significance of tumor response to induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (LANPC) patients and further to develop a nomogram for predicting survival prognosis.
METHODS
A total of 498 patients with stage III-IVA NPC applying IC and concurrent chemotherapy were reviewed (training cohort, n = 376; validation cohort, n = 122).
RESULTS
Tumor response was an independent predictor for clinical outcomes. The nomogram included age, N stage, pretreatment Epstein-Barr virus DNA, lymphocyte-to-monocyte ratio, and tumor response achieved an ideal C-index of 0.703 (95% CI 0.655-0.751) in the validation cohort for predicting overall survival (OS), which outperformed than that of the TNM system alone (C-index, 0.670, 95% CI: 0.622-0.718). In addition, the nomogram could successfully classified patients into different risk groups.
CONCLUSIONS
We established and validated a precise and convenient nomogram based on tumor response for predicting the OS of LANPC patients.
背景
评估局部晚期鼻咽癌（LANPC）患者诱导化疗（IC）后肿瘤反应的临床意义，并进一步开发预测生存预后的列线图。
方法
回顾了 498 例接受 IC 和同期化疗的 III-IVA 期 NPC 患者（训练队列，n=376；验证队列，n=122）。
结果
肿瘤反应是临床结局的独立预测因素。该列线图包括年龄、N 分期、治疗前 EBV-DNA、淋巴细胞与单核细胞比值和肿瘤反应，在验证队列中预测总生存（OS）的理想 C 指数为 0.703（95%CI：0.655-0.751），优于单独使用 TNM 系统（C 指数为 0.670，95%CI：0.622-0.718）。此外，该列线图可成功将患者分为不同的风险组。
结论
我们建立并验证了一个基于肿瘤反应的精确而便捷的列线图，用于预测 LANPC 患者的 OS。
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