Tumor residue in patients with stage II-IVA nasopharyngeal carcinoma who received intensity-modulated radiation therapy: development and validation of a prediction nomogram integrating postradiotherapy plasma Epstein-Barr virus deoxyribonucleic acid, clinical stage, and radiotherapy dose

被引:2
作者
Huang, Ying-Ying [1 ,2 ]
Zhou, Jia-Yu [1 ,2 ]
Zhan, Ze-Jiang [1 ,2 ]
Ke, Liang-Ru [1 ,3 ]
Xia, Wei-Xiong [1 ,2 ]
Cao, Xun [1 ,4 ]
Cai, Zhuo-Chen [1 ,2 ]
Deng, Ying [1 ,2 ]
Chen, Xi [1 ,2 ]
Zhang, Lu-Lu [1 ,2 ]
Huang, Hao-Yang [1 ,2 ]
Guo, Xiang [1 ,2 ]
Lv, Xing [1 ,2 ]
机构
[1] Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Guangdong Key Lab Nasopharyngeal Carcinoma Diag &, 651 Dongfeng East Rd, Guangzhou 510060, Peoples R China
[2] Sun Yat Sen Univ, Dept Nasopharyngeal Carcinoma, Canc Ctr, 651 Dongfeng East Rd, Guangzhou 510060, Peoples R China
[3] Sun Yat Sen Univ, Dept Med Imaging, Canc Ctr, 651 Dongfeng East Rd, Guangzhou 510060, Peoples R China
[4] Sun Yat Sen Univ, Dept Crit Care Med, Canc Ctr, 651 Dongfeng East Rd, Guangzhou 510060, Peoples R China
基金
中国国家自然科学基金;
关键词
Nasopharyngeal carcinoma; Intensity-modulated radiotherapy; Tumor residue; Epstein-Barr virus deoxyribonucleic acid; Prognostic value; Prediction nomogram; 8TH EDITION; DNA; CANCER; DISEASE; NODE; MRI;
D O I
10.1186/s12885-023-10827-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundTo develop and validate a predictive nomogram for tumor residue 3-6 months after treatment based on postradiotherapy plasma Epstein-Barr virus (EBV) deoxyribonucleic acid (DNA), clinical stage, and radiotherapy (RT) dose in patients with stage II-IVA nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT).MethodsIn this retrospective study, 1050 eligible patients with stage II-IVA NPC, who completed curative IMRT and underwent pretreatment and postradiotherapy (-7 to +28 days after IMRT) EBV DNA testing, were enrolled from 2012 to 2017. The prognostic value of the residue was explored using Cox regression analysis in patients (n=1050). A nomogram for predicting tumor residues after 3-6 months was developed using logistic regression analyses in the development cohort (n=736) and validated in an internal cohort (n=314).ResultsTumor residue was an independent inferior prognostic factor for 5-year overall survival, progression-free survival, locoregional recurrence-free survival and distant metastasis-free survival (all P<0.001). A prediction nomogram based on postradiotherapy plasma EBV DNA level (0 vs. 1-499 vs. >= 500 copies/ml), clinical stage (II vs. III vs. IVA), and RT dose (68.00-69.96 vs. 70.00-74.00 Gy) estimated the probability of residue development. The nomogram showed better discrimination (area under the curve (AUC): 0.752) than either the clinical stage (0.659) or postradiotherapy EBV DNA level (0.627) alone in the development and validation cohorts (AUC: 0.728).ConclusionsWe developed and validated a nomogram model integrating clinical characteristics at the end of IMRT for predicting whether tumor will residue or not after 3-6 months. Thus, high-risk NPC patients who might benefit from immediate additional intervention could be identified by the model, and the probability of residue can be reduced in the future.
引用
收藏
页数:13
相关论文
共 43 条
  • [1] The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging
    Amin, Mahul B.
    Greene, Frederick L.
    Edge, Stephen B.
    Compton, Carolyn C.
    Gershenwald, Jeffrey E.
    Brookland, Robert K.
    Meyer, Laura
    Gress, Donna M.
    Byrd, David R.
    Winchester, David P.
    [J]. CA-A CANCER JOURNAL FOR CLINICIANS, 2017, 67 (02) : 93 - 99
  • [2] Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up
    Bossi, P.
    Chan, A. T.
    Licitra, L.
    Trama, A.
    Orlandi, E.
    Hui, E. P.
    Halamkova, J.
    Mattheis, S.
    Baujat, B.
    Hardillo, J.
    Smeele, L.
    van Herpen, C.
    Castro, A.
    Machiels, J-P
    [J]. ANNALS OF ONCOLOGY, 2021, 32 (04) : 452 - 465
  • [3] Analysis of Plasma Epstein-Barr Virus DNA in Nasopharyngeal Cancer After Chemoradiation to Identify High-Risk Patients for Adjuvant Chemotherapy: A Randomized Controlled Trial
    Chan, Anthony T. C.
    Hui, Edwin P.
    Ngan, Roger K. C.
    Tung, Stewart Y.
    Cheng, Ashley C. K.
    Ng, Wai T.
    Lee, Victor H. F.
    Ma, Brigette B. Y.
    Cheng, Hoi C.
    Wong, Frank C. S.
    Loong, Herbert H. F.
    Tong, Macy
    Poon, Darren M. C.
    Ahuja, Anil T.
    King, Ann D.
    Wang, Ki
    Mo, Frankie
    Zee, Benny C. Y.
    Chan, K. C. Allen
    Lo, Y. M. Dennis
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2018, 36 (31) : 3091 - +
  • [4] Phase II study of neoadjuvant carboplatin and paclitaxel followed by radiotherapy and concurrent cisplatin in patients with locoregionally advanced nasopharyngeal carcinoma: Therapeutic monitoring with plasma Epstein-Barr virus DNA
    Chan, ATC
    Ma, BBY
    Lo, D
    Leung, SF
    Kwan, WH
    Hui, EP
    Mok, TSK
    Kam, M
    Chan, LS
    Chiu, SKW
    Yu, KH
    Cheung, KY
    Lai, K
    Lai, M
    Mo, F
    Yeo, W
    King, A
    Johnson, PJ
    Teo, PML
    Zee, B
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2004, 22 (15) : 3053 - 3060
  • [5] Chan ATC, 2002, JNCI-J NATL CANCER I, V94, P1614, DOI 10.1093/jnci/94.21.1614
  • [6] Metronomic capecitabine as adjuvant therapy in locoregionally advanced nasopharyngeal carcinoma: a multicentre, open-label, parallel-group, randomised, controlled, phase 3 trial
    Chen, Yu-Pei
    Liu, Xu
    Zhou, Qin
    Yang, Kun-Yu
    Jin, Feng
    Zhu, Xiao-Dong
    Shi, Mei
    Hu, Guo-Qing
    Hu, Wei-Han
    Sun, Yan
    Wu, Hong-Fen
    Wu, Hui
    Lin, Qin
    Wang, Hui
    Tian, Ye
    Zhang, Ning
    Wang, Xi-Cheng
    Shen, Liang-Fang
    Liu, Zheng-Zheng
    Huang, Jing
    Luo, Xiu-Ling
    Li, Ling
    Zang, Jian
    Mei, Qi
    Zheng, Bao-Min
    Yue, Dan
    Xu, Jing
    Wu, San-Gang
    Shi, Yan-Xia
    Mao, Yan-Ping
    Chen, Lei
    Li, Wen-Fei
    Zhou, Guan-Qun
    Sun, Rui
    Guo, Rui
    Zhang, Yuan
    Xu, Cheng
    Lv, Jia-Wei
    Guo, Ying
    Feng, Hui-Xia
    Tang, Ling-Long
    Xie, Fang-Yun
    Sun, Ying
    Ma, Jun
    [J]. LANCET, 2021, 398 (10297) : 303 - 313
  • [7] Chemotherapy in Combination With Radiotherapy for Definitive-Intent Treatment of Stage II-IVA Nasopharyngeal Carcinoma: CSCO and ASCO Guideline
    Chen, Yu-Pei
    Ismaila, Nofisat
    Chua, Melvin L. K.
    Colevas, A. Dimitrios
    Haddad, Robert
    Huang, Shao Hui
    Wee, Joseph T. S.
    Whitley, Alexander C.
    Yi, Jun-Lin
    Yom, Sue S.
    Chan, Anthony T. C.
    Hu, Chao-Su
    Lang, Jin-Yi
    Le, Quynh-Thu
    Lee, Anne W. M.
    Lee, Nancy
    Lin, Jin-Ching
    Ma, Brigette
    Morgan, Thomas J.
    Shah, Jatin
    Sun, Ying
    Ma, Jun
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2021, 39 (07) : 840 - +
  • [8] Nasopharyngeal carcinoma
    Chen, Yu-Pei
    Chan, Anthony T. C.
    Quynh-Thu Le
    Blanchard, Pierre
    Sun, Ying
    Ma, Jun
    [J]. LANCET, 2019, 394 (10192) : 64 - 80
  • [9] Detection and restaging of residual and/or recurrent nasopharyngeal carcinoma after chemotherapy and radiation therapy: Comparison of MR imaging and FDG PET/CT
    Comoretto, Maurizio
    Balestreri, Luca
    Borsatti, Eugenio
    Cimitan, Marino
    Franchin, Giovanni
    Lise, Mauro
    [J]. RADIOLOGY, 2008, 249 (01) : 203 - 211
  • [10] COMPARING THE AREAS UNDER 2 OR MORE CORRELATED RECEIVER OPERATING CHARACTERISTIC CURVES - A NONPARAMETRIC APPROACH
    DELONG, ER
    DELONG, DM
    CLARKEPEARSON, DI
    [J]. BIOMETRICS, 1988, 44 (03) : 837 - 845