机构:[1]Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China 临床科室其他部门放疗科华南肿瘤学国家重点实验室中山大学肿瘤防治中心[2] Department of Oncology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
Objectives: We have attempted to validate two published nomograms in nasopharyngeal carcinoma (NPC) and individualize induction chemotherapy (IC) accordingly. Materials and methods: From 2007 to 2011, 920 patients were included in the study. The validity of the nomograms was assessed by Harrell's concordance index (C-index), areas under the curve (AUC), and calibration curves. Disease-free survival (DFS) and overall survival (OS) by IC were evaluated in and out of risk stratified patients with and without propensity score matching analysis. Results: Compared with the 7th edition of the Union for International Cancer Control (UICC) staging system, Tang's nomogram better discriminated DFS (C-index 0.629 versus 0.569, P = 0.002; AUC 0.635 versus 0.576, P = 0.018), whereas Yang's nomogram had no advantage in predicting OS (C-index 0.648 versus 0.606, P = 0.184; AUC 0.643 versus 0.604, P = 0.157). Calibration curves indicated good agreement between predicted and observed DFS or OS probability. Without risk stratification, patients achieved no benefit from IC in DFS (P >= 0.101) or OS (P >= 0.370). However, among 580 high-risk patients stratified by Tang's nomogram, IC improved five-year DFS from 68.8 to 74.8% (P = 0.072), and OS from 82.6 to 87.9% (P = 0.065), and the improvement of DFS and OS increased to 9.3% (P = 0.019) and 7.3% (P = 0.036), respectively, in 426 propensity-matched patients. Conclusions: Tang's nomogram helps to stratify stage III-IVa-b NPC, and IC is beneficial to high-risk patients in clinical practice. (C) 2017 The Authors. Published by Elsevier Ltd.
基金:
Sun Yat-sen University Clinical Research 5010 Program [2015020]; National Natural Science Foundation of China [81672665]; Sci-Tech Project Foundation of Guangdong Province [2016A020215087]; Natural Science Foundation of Guangdong Province [2015A030313024]
语种:
外文
被引次数:
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出版当年[2017]版:
大类|2 区医学
小类|1 区牙科与口腔外科3 区肿瘤学
最新[2023]版:
大类|2 区医学
小类|2 区牙科与口腔外科3 区肿瘤学
第一作者:
第一作者机构:[1]Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
共同第一作者:
通讯作者:
通讯机构:[1]Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China [*1]Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651 Dongfeng Road East, Guangzhou 510060, China.
推荐引用方式(GB/T 7714):
OuYang Pu-Yun,Zhang Lu-Ning,Xiao Yao,et al.Validation of published nomograms and accordingly individualized induction chemotherapy in nasopharyngeal carcinoma[J].ORAL ONCOLOGY.2017,67:37-45.doi:10.1016/j.oraloncology.2017.01.009.
APA:
OuYang, Pu-Yun,Zhang, Lu-Ning,Xiao, Yao,Lan, Xiao-Wen,Zhang, Xiao-Min...&Xie, Fang-Yun.(2017).Validation of published nomograms and accordingly individualized induction chemotherapy in nasopharyngeal carcinoma.ORAL ONCOLOGY,67,
MLA:
OuYang, Pu-Yun,et al."Validation of published nomograms and accordingly individualized induction chemotherapy in nasopharyngeal carcinoma".ORAL ONCOLOGY 67.(2017):37-45