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Proposal of a Pretreatment Nomogram for Predicting Local Recurrence after Intensity-Modulated Radiation Therapy in T4 Nasopharyngeal Carcinoma: A Retrospective Review of 415 Chinese Patients
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Lu-Lu Zhang, Yi-Yang Li, Jiang Hu, Guan-Qun Zhou, Lei Chen, Wen-Fei Li, Ai-Hua Lin, Jun Ma, Zhen-Yu Qi, Ying Sun
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Cancer Res Treat. 2018;50(4):1084-1095. Published online November 15, 2017
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DOI: https://doi.org/10.4143/crt.2017.359
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 Abstract
 PDF PubReader ePub
- Purpose
Local relapse-free survival (LRFS) differs widely among patients with T4 category nasopharyngeal carcinoma (NPC). We aimed to build a nomogram incorporating clinicopathological information to predict LRFS in T4 NPC after definitive intensity-modulated radiation therapy (IMRT).
Materials and Methods
Retrospective study of 415 Chinese patients with non-metastatic T4 NPC treated with definitive IMRT with or without chemotherapy at our cancer center between October 2009 and September 2013. The nomogram for LRFS at 3 and 5 years was generated based on multivariate Cox proportional hazards regression, and validated using bootstrap resampling, assessing discriminative performance using the concordance index (C-index) and determining calibration ability via calibration curves.
Results
Five-year LRFS was 88.8%. We identified and incorporated four independent prognostic factors for LRFS: ethmoid sinus invasion, primary gross tumor volume, age, and pretreatment body mass index. The C-index of the nomogram for local recurrence was 0.732 (95% confidence interval, 0.726 to 0.738), indicating excellent predictive accuracy. The calibration curve revealed excellent agreement between nomogram-predicted and observed LRFS probabilities. Risk subgroups based on total point score cutoff values enabled effective discrimination of LRFS.
Conclusion
This pretreatment nomogram enables clinicians to accurately predict LRFS in T4 NPC after definitive IMRT, and could help to facilitate personalized patient counselling and treatment strategies.
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Neutropenia during the First Cycle of Induction Chemotherapy Is Prognostic for Poor Survival in Locoregionally Advanced Nasopharyngeal Carcinoma: A Real-World Study in an Endemic Area
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Cheng Xu, Shi-Ping Yang, Yuan Zhang, Ling-Long Tang, Guan-Qun Zhou, Xu Liu, Yan-Ping Mao, Rui Guo, Wen-Fei Li, Lei Chen, Ai-Hua Lin, Ying Sun, Jun Ma
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Cancer Res Treat. 2018;50(3):777-790. Published online July 24, 2017
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DOI: https://doi.org/10.4143/crt.2017.255
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Abstract
PDF
 Supplementary MaterialPubReaderePub
- Purpose
The purpose of this study was to investigate the effect of neutropenia during the first cycle of induction chemotherapy (IC-1) on survival in locoregionally advanced nasopharyngeal carcinoma (LANPC).
Materials and Methods
Eligible patients (n=545) with LANPC receiving IC+concurrent chemoradiotherapy were included. Based on nadir neutrophil afterIC-1, all patientswere categorized into three groups: no/grade 1-2/grade 3-4 neutropenia. Five-year overall survival (OS) and disease-free survival (DFS) were compared between groups and subgroups stratified by IC regimen. We also explored the occurrence of IC-1–induced myelosuppression events and the minimal value of post-treatment neutrophil-to-lymphocyte ratio (post-NLRmin). Univariate/multivariate analyses were performed to investigate the effect of IC-1–induced neutropenia, timing of neutropenia, number of myelosuppression events, and high post-NLRmin on OS/DFS.
Results
Grade 1-2/grade 3-4 neutropeniawere associatedwith poorer OS/DFS than no neutropenia (all p < 0.05); OS/DFS were not significantly different between patients experiencing grade 1-2 vs. 3-4 neutropenia. Neutropenia had no significant effect on OS/DFS in patients receiving docetaxel–cisplatin–5-fluorouracil (TPF). Grade 1-2 (grade 3-4) neutropenia negatively influenced OS/DFS in patients receiving cisplatin–5-fluorouracil (PF) (PF and docetaxel–cisplatin [TP]; all p < 0.05). Neutropenia, two/three myelosuppression events, and high post-NLRmin (≥ 1.33) was most frequent on days 5-10, second and third week of IC-1, respectively. After adjustment for covariates, IC-1–induced neutropenia, two/three myelosuppression events, and post-NLRmin ≥ 1.33were validated as negative predictors of OS/DFS (all p < 0.05); timing of neutropenia had no significant effect.
Conclusion
Occurrence of neutropenia, number of myelosuppression events, and high post-NLRmin during PF/TP IC-1 have prognostic value for poor survival in LANPC.
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Citations
Citations to this article as recorded by - Prospective clinical study of the efficacy and safety of different doses of PEG recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) for preventing leukopenia/neutropenia caused by concurrent chemoradiotherapy for cervical cancer
Tingting Yu, Yiwei Zhang, Jiawen Li, Zhuo Li, Rui Tong
Holistic Integrative Oncology.2024;[Epub] CrossRef - Incidence, consequences, and predictors of serious chemotherapy‐induced thrombocytopenia in nasopharyngeal carcinoma
Lu‐Lu Zhang, Xi Chen, Ying‐Ying Huang, Chi‐Xiong Liang, Meng‐Yun Qiang, Zhuo‐Chen Cai, Ze‐Jiang Zhan, Ying Deng, Jia‐Yu Zhou, Hao‐Yang Huang, Xiang Guo, Xing Lv
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Jun Wang, Baosheng Li
Precision Radiation Oncology.2021; 5(1): 4. CrossRef - Prognostic value of serum uric acid and tumor response to induction chemotherapy in locally advanced nasopharyngeal carcinoma
Yuanji Xu, Zijie Wu, Wangzhong Ye, Youping Xiao, Wei Zheng, Qinyan Chen, Penggang Bai, Zhizhong Lin, Chuanben Chen
BMC Cancer.2021;[Epub] CrossRef - Time-to-Event Supervised Genetic Algorithm Enables Induction Chemotherapy Decision Making for Nasopharyngeal Carcinoma
Demin Liu, Haojiang Li, Liyang Wu, Shuchao Chen, Tianqiao Zhang, Wenjie Huang, Guangying Ruan, Sai Li, Lizhi Liu, Hongbo Chen
IEEE Access.2021; 9: 98701. CrossRef - Prognostic value of post-radiotherapy neutrophil-to-lymphocyte ratio in locally advanced nasopharyngeal carcinoma
Dan Ou, Xiaoshen Wang, Mingyao Wu, Fen Xue, Yujiao Li, Chaosu Hu, Xiayun He
Strahlentherapie und Onkologie.2020; 196(3): 252. CrossRef - Amelioration of cyclophosphamide-induced myelosuppression during treatment to rats with breast cancer through low-intensity pulsed ultrasound
Wei Wang, Dong Luo, Junlin Chen, Jinyun Chen, Yi Xia, Wenzhi Chen, Yan Wang
Bioscience Reports.2020;[Epub] CrossRef
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A National Study of Survival Trends and Conditional Survival in Nasopharyngeal Carcinoma: Analysis of the National Population-Based Surveillance Epidemiology and End Results Registry
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Jia-Wei Lv, Xiao-Dan Huang, Yu-Pei Chen, Guan-Qun Zhou, Ling-Long Tang, Yan-Ping Mao, Wen-Fei Li, Ai-Hua Lin, Jun Ma, Ying Sun
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Cancer Res Treat. 2018;50(2):324-334. Published online April 19, 2017
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DOI: https://doi.org/10.4143/crt.2016.544
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Abstract
PDFPubReaderePub
- Purpose
Conditional survival (CS) provides important information on survival for a period of time after diagnosis. Currently, information on CS patterns of patients with nasopharyngeal carcinoma (NPC) is lacking. We aimed to analyze survival rate over time and estimate CS for NPC patients using a national population-based registry.
Materials and Methods
Patients diagnosed with NPC between 1973 and 2007 with at least 5-year follow-up were identified from the Surveillance Epidemiology End Results registry. Traditional survival rates and crude CS estimateswere calculated using Kaplan-Meier analysis. Risk-adjusted survival curves were plotted from the proportional hazards model using the correct group prognosis method.
Results
For 7,713 patients analyzed, adjusted baseline 5-year overall survival improved significantly from 36.0% in patients diagnosed in 1973-1979, 41.7% in 1980-1989, 46.6% in 1990- 1999, to 54.7% in 2000-2007 (p < 0.01). CS analysis demonstrated that for every additional year survived, adjusted probability of surviving the next 5 years increased from 66.7% (localized), 54.0% (regional), and 35.3% (distant) at the time of diagnosis, to 83.7% (localized), 75.0% (regional), and 62.2% (distant) for patients who had survived 5 years. Adjusted 5-year CS differed among age, sex, tumor histology, ethnicity, and stage subgroups initially, but converged with time.
Conclusion
Treatment outcomes of NPC patients have greatly improved over the decades. Increases in CS become more prominent in patients with distant disease than in those with localized or regional disease as patients survive longer. CS provides more dynamic prognostic information for patients who have survived a period of time after diagnosis.
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Citations
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Acta Oto-Laryngologica.2024; 144(4): 325. CrossRef - Health and Well-Being Needs Among Head and Neck Cancer Caregivers – A Systematic Review
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Annals of Otology, Rhinology & Laryngology.2023; 132(4): 449. CrossRef - Constructing an individualized surveillance framework for nasopharyngeal carcinoma based on a dynamic risk-adapted approach
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HPB.2022;[Epub] CrossRef - Epstein–Barr Virus (EBV) Epithelial Associated Malignancies: Exploring Pathologies and Current Treatments
Oren Shechter, Daniel G. Sausen, Elisa S. Gallo, Harel Dahari, Ronen Borenstein
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Susanna Hilda Hutajulu, Daniel Howdon, Kartika Widayati Taroeno-Hariadi, Mardiah Suci Hardianti, Ibnu Purwanto, Sagung Rai Indrasari, Camelia Herdini, Bambang Hariwiyanto, Ahmad Ghozali, Henry Kusumo, Wigati Dhamiyati, Sri Retna Dwidanarti, I. Bing Tan, J
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