Prognostic scoring system for locoregional control among the patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy |
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| Authors: | Chang-Juan Tao Xu Liu Ling-Long Tang Yan-Ping Mao Lei Chen Wen-Fei Li Xiao-Li Yu Li-Zhi Liu Rong Zhang Ai-Hua Lin Jun Ma Ying Sun |
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| Affiliation: | Chang-Juan Tao (State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China)； Xu Liu (State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China)； Ling-Long Tang (State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China)； Yan-Ping Mao (State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China)； Lei Chen (State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China)； Wen-Fei Li (State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China)； Xiao-Li Yu (State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China)； Li-Zhi Liu (State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China)； Rong Zhang (State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China)； Ai-Hua Lin (Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, P. R. China)； Jun Ma (State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China)； Ying Sun (State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China)； |
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| Abstract: | The prognostic value of T category for locoregional control in patients with nasopharyngeal carcinoma (NPC) has decreased with the extensive use of intensity-modulated radiotherapy (IMRT). We aimed to develop a prognostic scoring system (PSS) that incorporated tumor extension and clinical characteristics for locoregional control in NPC patients treated with IMRT. The magnetic resonance imaging scans and medical records of 717 patients with nonmetastatic NPC treated with IMRT at Sun Yat-sen University Cancer Center between January 2003 and January 2008 were reviewed. Age, pathologic classification, primary tumor extension, primary gross tumor volume (GTV-p), T and N categories, and baseline lactate dehydrogenase (LDH) level were analyzed. Hierarchical cluster analysis as well as univariate and multivariate analyses were used to develop the PSS. Independent prognostic factors for locoregional relapse included N2-3 stage, GTV-p≥26.8 mL, and involvement of one or more structures within cluster 3. We calculated a risk score derived from the regression coefficient of each factor and classified patients into four groups:low risk (score 0), intermediate risk (score>0 and≤1), high risk (score>1 and≤2), and extremely high risk (score>2). The 5-year locoregional control rates for these groups were 97.4%, 93.6%, 85.2%, and 78.6%, respectively (P<0.001). We have developed a PSS that can help identify NPC patients who are at high risk for locoregional relapse and can guide individualized treatments for NPC patients. |
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