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A Nomogram to Identify the Optimal Candidates for Induction Chemotherapy in Advanced N-Stage Nasopharyngeal Carcinoma

PURPOSE: We aimed to select optimal candidates benefiting from the addition of induction chemotherapy (IC) to concurrent chemoradiotherapy (CCRT) in advanced N-stage nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: A total of 624 NPC patients with N2-3 stage received CCRT with or without IC wer...

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Autores principales: Jiang, Yu-Ting, Chen, Kai-Hua, Liang, Zhong-Guo, Yang, Jie, Qu, Song, Li, Ling, Zhu, Xiao-Dong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441150/
https://www.ncbi.nlm.nih.gov/pubmed/36068822
http://dx.doi.org/10.2147/CMAR.S377731
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author Jiang, Yu-Ting
Chen, Kai-Hua
Liang, Zhong-Guo
Yang, Jie
Qu, Song
Li, Ling
Zhu, Xiao-Dong
author_facet Jiang, Yu-Ting
Chen, Kai-Hua
Liang, Zhong-Guo
Yang, Jie
Qu, Song
Li, Ling
Zhu, Xiao-Dong
author_sort Jiang, Yu-Ting
collection PubMed
description PURPOSE: We aimed to select optimal candidates benefiting from the addition of induction chemotherapy (IC) to concurrent chemoradiotherapy (CCRT) in advanced N-stage nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: A total of 624 NPC patients with N2-3 stage received CCRT with or without IC were retrospectively reviewed. We constructed a nomogram for predicting overall survival (OS) based on the result of the multivariate analysis in the training cohort (n = 468) and then tested it on the validation cohort (n = 156). Harrell’s concordance indices (C-index) and time-independent receiver operating characteristic (tdROC) analysis were applied to evaluate the discriminatory ability of the nomogram and compare it with TNM staging. IC plus CCRT was compared with CCRT in the whole cohort and two risk groups based on the nomogram with balanced baseline characteristics. In addition, acute toxicities were compared between different treatment groups. RESULTS: The nomogram showed good prognostic accuracy with a C-index of 0.716 (95% CI 0.669–0.763) in the validation cohort. The 5-year OS of low and high-risk groups stratified by the nomogram were significantly different. IC+CCRT was significantly associated with superior OS as compared with CCRT (75.4 vs 52.6%, p = 0.009) in the high-risk group. However, no significant difference between IC plus CCRT and CCRT was observed (p = 0.843) in the low-risk group. IC plus CCRT was associated with more grade 1–4 acute toxicities. CONCLUSION: Our study can help clinicians select NPC patients with advanced N stage who benefit from IC.
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spelling pubmed-94411502022-09-05 A Nomogram to Identify the Optimal Candidates for Induction Chemotherapy in Advanced N-Stage Nasopharyngeal Carcinoma Jiang, Yu-Ting Chen, Kai-Hua Liang, Zhong-Guo Yang, Jie Qu, Song Li, Ling Zhu, Xiao-Dong Cancer Manag Res Original Research PURPOSE: We aimed to select optimal candidates benefiting from the addition of induction chemotherapy (IC) to concurrent chemoradiotherapy (CCRT) in advanced N-stage nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: A total of 624 NPC patients with N2-3 stage received CCRT with or without IC were retrospectively reviewed. We constructed a nomogram for predicting overall survival (OS) based on the result of the multivariate analysis in the training cohort (n = 468) and then tested it on the validation cohort (n = 156). Harrell’s concordance indices (C-index) and time-independent receiver operating characteristic (tdROC) analysis were applied to evaluate the discriminatory ability of the nomogram and compare it with TNM staging. IC plus CCRT was compared with CCRT in the whole cohort and two risk groups based on the nomogram with balanced baseline characteristics. In addition, acute toxicities were compared between different treatment groups. RESULTS: The nomogram showed good prognostic accuracy with a C-index of 0.716 (95% CI 0.669–0.763) in the validation cohort. The 5-year OS of low and high-risk groups stratified by the nomogram were significantly different. IC+CCRT was significantly associated with superior OS as compared with CCRT (75.4 vs 52.6%, p = 0.009) in the high-risk group. However, no significant difference between IC plus CCRT and CCRT was observed (p = 0.843) in the low-risk group. IC plus CCRT was associated with more grade 1–4 acute toxicities. CONCLUSION: Our study can help clinicians select NPC patients with advanced N stage who benefit from IC. Dove 2022-08-31 /pmc/articles/PMC9441150/ /pubmed/36068822 http://dx.doi.org/10.2147/CMAR.S377731 Text en © 2022 Jiang et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Jiang, Yu-Ting
Chen, Kai-Hua
Liang, Zhong-Guo
Yang, Jie
Qu, Song
Li, Ling
Zhu, Xiao-Dong
A Nomogram to Identify the Optimal Candidates for Induction Chemotherapy in Advanced N-Stage Nasopharyngeal Carcinoma
title A Nomogram to Identify the Optimal Candidates for Induction Chemotherapy in Advanced N-Stage Nasopharyngeal Carcinoma
title_full A Nomogram to Identify the Optimal Candidates for Induction Chemotherapy in Advanced N-Stage Nasopharyngeal Carcinoma
title_fullStr A Nomogram to Identify the Optimal Candidates for Induction Chemotherapy in Advanced N-Stage Nasopharyngeal Carcinoma
title_full_unstemmed A Nomogram to Identify the Optimal Candidates for Induction Chemotherapy in Advanced N-Stage Nasopharyngeal Carcinoma
title_short A Nomogram to Identify the Optimal Candidates for Induction Chemotherapy in Advanced N-Stage Nasopharyngeal Carcinoma
title_sort nomogram to identify the optimal candidates for induction chemotherapy in advanced n-stage nasopharyngeal carcinoma
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441150/
https://www.ncbi.nlm.nih.gov/pubmed/36068822
http://dx.doi.org/10.2147/CMAR.S377731
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