Development of A Nomogram for Progression-free Survival in Patients with Stage II/T3N0 Nasopharyngeal Carcinoma to Explore Different Treatment Modalities

Yan, Chang; Zhao, Rong; Chen, Kai-Hua; Chen, Biao-You; Zhang, Chao-Jun; Chen, Xi; Meng, Wan-Wan; Lai, Lin; Qu, Song; Zhu, Xiao-Dong

doi:10.7150/jca.87901

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J Cancer 2023; 14(17):3368-3377. doi:10.7150/jca.87901 This issue Cite

Research Paper

Development of A Nomogram for Progression-free Survival in Patients with Stage II/T3N0 Nasopharyngeal Carcinoma to Explore Different Treatment Modalities

Chang Yan^1*, Rong Zhao^1*, Kai-Hua Chen¹, Biao-You Chen¹, Chao-Jun Zhang¹, Xi Chen¹, Wan-Wan Meng¹, Lin Lai¹, Song Qu¹, Xiao-Dong Zhu^1,2✉

1. Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China.
2. Department of Oncology, Wuming Hospital of Guangxi Medical University, Nanning, Guangxi, 530199, People's Republic of China.
*These authors contributed equally to this work.

Citation:

Yan C, Zhao R, Chen KH, Chen BY, Zhang CJ, Chen X, Meng WW, Lai L, Qu S, Zhu XD. Development of A Nomogram for Progression-free Survival in Patients with Stage II/T3N0 Nasopharyngeal Carcinoma to Explore Different Treatment Modalities. J Cancer 2023; 14(17):3368-3377. doi:10.7150/jca.87901. https://www.jcancer.org/v14p3368.htm

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Abstract

Purpose To explore the prognostic value of clinical and serological risk factors for progression-free survival (PFS) in stage II and T3N0 nasopharyngeal carcinoma (NPC) and construct a nomogram based on these factors. Additionally, to investigate the long-term survival and short-term toxic reactions of patients in different risk stratification under different treatment modalities.

Methods The patients were randomly divided into training and validation cohorts in a 7:3 ratio. Independent prognostic factors were identified using Cox regression analysis, and a nomogram was constructed by combining these predictive factors with the TNM staging system. The nomogram was then validated in the validation cohort, and patients were classified into different risk groups based on the nomogram. The PFS, overall survival (OS), and acute toxicities were compared among different treatment modalities after balancing baseline characteristics.

Results Multivariate Cox regression analysis indicated that pathological type, alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were independent prognostic factors(p<0.05) in this study. The nomogram showed good prognostic accuracy in both the training and validation cohorts (C-index of 0.73 and 0.70, respectively). In the different risk subgroups, there were no statistically significant differences in PFS and OS between radiotherapy and chemoradiotherapy groups(p>0.05). The treatment modality of combined chemotherapy was associated with more acute toxic reactions.

Conclusion We established and validated a nomogram for predicting PFS in patients with stage II/T3N0 NPC. Intensity-modulated radiation therapy (IMRT) combined with chemotherapy did not provide additional survival benefits for these patients and was associated with more chemotherapy-related side effects.

Keywords: nasopharyngeal carcinoma, survival, intensity-modulated radiotherapy, nomogram

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APA

Yan, C., Zhao, R., Chen, K.H., Chen, B.Y., Zhang, C.J., Chen, X., Meng, W.W., Lai, L., Qu, S., Zhu, X.D. (2023). Development of A Nomogram for Progression-free Survival in Patients with Stage II/T3N0 Nasopharyngeal Carcinoma to Explore Different Treatment Modalities. Journal of Cancer, 14(17), 3368-3377. https://doi.org/10.7150/jca.87901.

ACS

Yan, C.; Zhao, R.; Chen, K.H.; Chen, B.Y.; Zhang, C.J.; Chen, X.; Meng, W.W.; Lai, L.; Qu, S.; Zhu, X.D. Development of A Nomogram for Progression-free Survival in Patients with Stage II/T3N0 Nasopharyngeal Carcinoma to Explore Different Treatment Modalities. J. Cancer 2023, 14 (17), 3368-3377. DOI: 10.7150/jca.87901.

NLM

CSE

Yan C, Zhao R, Chen KH, Chen BY, Zhang CJ, Chen X, Meng WW, Lai L, Qu S, Zhu XD. 2023. Development of A Nomogram for Progression-free Survival in Patients with Stage II/T3N0 Nasopharyngeal Carcinoma to Explore Different Treatment Modalities. J Cancer. 14(17):3368-3377.

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