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A Nomogram for the Determination of the Necessity of Concurrent Chemotherapy in Patients With Stage II–IVa Nasopharyngeal Carcinoma
BACKGROUND: The efficiency of concurrent chemotherapy (CC) remains controversial for stage II–IVa nasopharyngeal carcinoma (NPC) patients treated with induction chemotherapy (IC) followed by intensity-modulated radiotherapy (IMRT). Therefore, we aimed to propose a nomogram to identify patients who w...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450530/ https://www.ncbi.nlm.nih.gov/pubmed/34552862 http://dx.doi.org/10.3389/fonc.2021.640077 |
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author | Yang, Kaixuan Zhang, Qian Zhang, Mengxi Xie, Wenji Li, Mei Zeng, Lei Wang, Qiang Zhao, Jianling Li, Yiping Li, Guangjun |
author_facet | Yang, Kaixuan Zhang, Qian Zhang, Mengxi Xie, Wenji Li, Mei Zeng, Lei Wang, Qiang Zhao, Jianling Li, Yiping Li, Guangjun |
author_sort | Yang, Kaixuan |
collection | PubMed |
description | BACKGROUND: The efficiency of concurrent chemotherapy (CC) remains controversial for stage II–IVa nasopharyngeal carcinoma (NPC) patients treated with induction chemotherapy (IC) followed by intensity-modulated radiotherapy (IMRT). Therefore, we aimed to propose a nomogram to identify patients who would benefit from CC. METHODS: A total of 434 NPC patients (stage II–IVa) treated with IC followed by IMRT between January 2010 and December 2015 were included. There were 808 dosimetric parameters extracted by the in-house script for each patient. A dosimetric signature was developed with the least absolute shrinkage and selection operator algorithm. A nomogram was built by incorporating clinical factors and dosimetric signature using Cox regression to predict recurrence-free survival (RFS). The C-index was used to evaluate the performance of the nomogram. The patients were stratified into low- and high-risk recurrence according to the optimal cutoff of risk score. RESULTS: The nomogram incorporating age, TNM stage, and dosimetric signature yielded a C-index of 0.719 (95% confidence interval, 0.658–0.78). In the low-risk group, CC was associated with a 9.4% increase of 5-year locoregional RFS and an 8.8% increase of 5-year overall survival (OS), whereas it was not significantly associated with an improvement of locoregional RFS (LRFS) and OS in the high-risk group. However, in the high-risk group, patients could benefit from adjuvant chemotherapy (AC) by improving 33.6% of the 5-year LRFS. CONCLUSIONS: The nomogram performed an individualized risk quantification of RFS in patients with stage II–IVa NPC treated with IC followed by IMRT. Patients with low risk could benefit from CC, whereas patients with high risk may require additional AC. |
format | Online Article Text |
id | pubmed-8450530 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84505302021-09-21 A Nomogram for the Determination of the Necessity of Concurrent Chemotherapy in Patients With Stage II–IVa Nasopharyngeal Carcinoma Yang, Kaixuan Zhang, Qian Zhang, Mengxi Xie, Wenji Li, Mei Zeng, Lei Wang, Qiang Zhao, Jianling Li, Yiping Li, Guangjun Front Oncol Oncology BACKGROUND: The efficiency of concurrent chemotherapy (CC) remains controversial for stage II–IVa nasopharyngeal carcinoma (NPC) patients treated with induction chemotherapy (IC) followed by intensity-modulated radiotherapy (IMRT). Therefore, we aimed to propose a nomogram to identify patients who would benefit from CC. METHODS: A total of 434 NPC patients (stage II–IVa) treated with IC followed by IMRT between January 2010 and December 2015 were included. There were 808 dosimetric parameters extracted by the in-house script for each patient. A dosimetric signature was developed with the least absolute shrinkage and selection operator algorithm. A nomogram was built by incorporating clinical factors and dosimetric signature using Cox regression to predict recurrence-free survival (RFS). The C-index was used to evaluate the performance of the nomogram. The patients were stratified into low- and high-risk recurrence according to the optimal cutoff of risk score. RESULTS: The nomogram incorporating age, TNM stage, and dosimetric signature yielded a C-index of 0.719 (95% confidence interval, 0.658–0.78). In the low-risk group, CC was associated with a 9.4% increase of 5-year locoregional RFS and an 8.8% increase of 5-year overall survival (OS), whereas it was not significantly associated with an improvement of locoregional RFS (LRFS) and OS in the high-risk group. However, in the high-risk group, patients could benefit from adjuvant chemotherapy (AC) by improving 33.6% of the 5-year LRFS. CONCLUSIONS: The nomogram performed an individualized risk quantification of RFS in patients with stage II–IVa NPC treated with IC followed by IMRT. Patients with low risk could benefit from CC, whereas patients with high risk may require additional AC. Frontiers Media S.A. 2021-09-06 /pmc/articles/PMC8450530/ /pubmed/34552862 http://dx.doi.org/10.3389/fonc.2021.640077 Text en Copyright © 2021 Yang, Zhang, Zhang, Xie, Li, Zeng, Wang, Zhao, Li and Li https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Yang, Kaixuan Zhang, Qian Zhang, Mengxi Xie, Wenji Li, Mei Zeng, Lei Wang, Qiang Zhao, Jianling Li, Yiping Li, Guangjun A Nomogram for the Determination of the Necessity of Concurrent Chemotherapy in Patients With Stage II–IVa Nasopharyngeal Carcinoma |
title | A Nomogram for the Determination of the Necessity of Concurrent Chemotherapy in Patients With Stage II–IVa Nasopharyngeal Carcinoma |
title_full | A Nomogram for the Determination of the Necessity of Concurrent Chemotherapy in Patients With Stage II–IVa Nasopharyngeal Carcinoma |
title_fullStr | A Nomogram for the Determination of the Necessity of Concurrent Chemotherapy in Patients With Stage II–IVa Nasopharyngeal Carcinoma |
title_full_unstemmed | A Nomogram for the Determination of the Necessity of Concurrent Chemotherapy in Patients With Stage II–IVa Nasopharyngeal Carcinoma |
title_short | A Nomogram for the Determination of the Necessity of Concurrent Chemotherapy in Patients With Stage II–IVa Nasopharyngeal Carcinoma |
title_sort | nomogram for the determination of the necessity of concurrent chemotherapy in patients with stage ii–iva nasopharyngeal carcinoma |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450530/ https://www.ncbi.nlm.nih.gov/pubmed/34552862 http://dx.doi.org/10.3389/fonc.2021.640077 |
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