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Pretreatment Nomograms for Local and Regional Recurrence after Radical Radiation Therapy for Primary Nasopharyngeal Carcinoma

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机构: [1]Sun Yat Sen Univ, Canc Ctr, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol Southern China,Dept Radiat On, Guangzhou 510060, Guangdong, Peoples R China; [2]Sun Yat Sen Univ, Sch Publ Hlth, Dept Med Stat & Epidemiol, Guangzhou, Guangdong, Peoples R China; [3]Sun Yat Sen Univ, Canc Ctr, Collaborat Innovat Ctr Canc Med, Dept Radiat Oncol,State Key Lab Oncol South China, 651 Dongfeng Rd East, Guangzhou 510060, Guangdong, Peoples R China
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关键词: Nomogram Local Recurrence Regional Recurrence Nasopharyngeal Carcinoma Intensity-Modulated Radiation Therapy

摘要:
Background: The aim of this study was to build nomograms to predict local recurrence (LR) and regional recurrence (RR) in patients with nasopharyngeal carcinoma (NPC) underwent intensity-modulated radiation therapy (IMRT). Patients and Methods: A total of 1811 patients with non-metastatic NPC treated with IMRT (with or without chemotherapy) between October 2009 and February 2012 at our center were involved for building the nomograms. Nomograms for LR-free rate and RR-free rate at 3- and 5year were generated as visualizations of Cox proportional hazards regression models, and validated using bootstrap resampling, estimating discrimination and calibration. Results: With a median follow up of 49.50 months, the 3- and 5-year LR-free rate were 95.43% and 94.30% respectively; the 3- and 5-year RR-free rate were 95.94% and 95.41% respectively. The final predictive model for LR included age, the neutrophil/leukocyte ratio (NWR), pathological type, primary gross tumor volume, maxillary sinus invasion, ethmoidal sinus invasion and lacerated foramen invasion; the model for RR involved NWR, plasma Epstein-Barr virus (EBV) DNA copy number, cervical lymph node volume and N category. The models showed fairly good discriminatory ability with concordance indices (c-indices) of 0.76 and 0.74 for predicting LR and RR, respectively, as well as good calibration. The proposed stratification of risk groups based on the nomograms allowed significant distinction between Kaplan-Meier curves for LR and RR. Conclusions: The proposed nomograms resulted in more-accurate prognostic prediction for LR and RR with a high concordance, hence to inform patients with high risk of recurrence on more aggressive therapy. The prognostic nomograms could better stratify patients into different risk groups.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 肿瘤学
第一作者:
第一作者机构: [1]Sun Yat Sen Univ, Canc Ctr, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol Southern China,Dept Radiat On, Guangzhou 510060, Guangdong, Peoples R China;
通讯作者:
通讯机构: [1]Sun Yat Sen Univ, Canc Ctr, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol Southern China,Dept Radiat On, Guangzhou 510060, Guangdong, Peoples R China; [3]Sun Yat Sen Univ, Canc Ctr, Collaborat Innovat Ctr Canc Med, Dept Radiat Oncol,State Key Lab Oncol South China, 651 Dongfeng Rd East, Guangzhou 510060, Guangdong, Peoples R China
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