Ten-year outcomes of survival and toxicity for a phase III randomised trial of concurrent chemoradiotherapy versus radiotherapy alone in stage II nasopharyngeal carcinoma

Li, Xiaoyun; Chen, Qiuyan; Sun, Xia; Liu, Sai-Lan; Yan, Jin-Jie; Guo, Shan-Shan; Liu, Liting; Xie, Haojun; Tang, Qing-Nan; Liang, Yu-Jing; Wen, Yihui; Guo, Ling; Mo, Hao‐Yuan; Chen, Ming‐Yuan; Sun, Ying; Ma, Jun; Tang, Lin‐Quan; Mai, Hai-Qiang

doi:10.1016/j.ejca.2018.10.020

Cited by 43 publications

(20 citation statements)

References 18 publications

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“…This system is used for treatment selection, cancer control strategies and outcome prediction. Concurrent chemoradiotherapy has been regarded as the standard treatment for NPC because of the covert nature of the tumorigenic site and intrinsic sensitivity of radiotherapy (2,3). Over the years, radiotherapy technology has evolved from two-dimensional radiotherapy (2DRT) to intensity-modulated radiotherapy (IMRT) and this has resulted in longer survival and milder toxicity in NPC patients (4).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma

et al. 2020

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Inflammation and nutritional status have significant effects on the prognosis of cancer patients. This study investigated the predictive value of clinical biochemistry-based indexes in nasopharyngeal carcinoma (NPC). This retrospective study included 559 NPC patients and 500 patients with chronic rhinitis. Continuous variables were measured by t-test. The area under curves (AUC) was used to determine the diagnostic and prognostic value for NPC. Kaplan-Meier methods and the log-rank test were used to analyze overall survival (OS) and disease-free survival (DFS) of the patients. Cox and logistic regression analysis were used to analyze the independent prognostic risk factors for survival and influencing factors of side effects after treatment, respectively. The study results revealed that most indexes of NPC and rhinitis were significantly different between the two groups. In the survival analysis, the systemic inflammation score (SIS), prognostic nutritional index (PNI), albumin/globulin ratio (AGR), albumin (ALB), urea nitrogen (BUN) and creatinine (CREA) had significant influence on the OS and DFS. AGR was the optimal prognostic indicator for NPC. Among these indexes, SIS, AGR, BUN and CERA were independent prognostic factors of OS, AGR and PNI were independent prognostic factors of DFS. Most indexes were risk factors of side effects occurred in radiotherapy. In conclusion, the clinical biochemistry-based indexes, are reliable and of low-cost, therefore, they can be used in predicting diagnosis, prognosis and treatment plans of NPC.

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Section: Introductionmentioning

confidence: 99%

Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma

et al. 2020

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“…Concurrent chemoradiotherapy (CCRT) has been proven effective for stage II‐IVa NPC in the 2DRT era 6,20,21 . With the transformation of 2DRT to IMRT in radiotherapy modality, our study also demonstrated that the addition of CC to IMRT confers OS and PFS benefits to patients treated with IC followed by IMRT.…”

Section: Discussionmentioning

confidence: 59%

Nomograms for predicting survival outcomes in intensity‐modulated radiotherapy era of nasopharyngeal carcinoma: A study based on Epstein–Barr virus DNA biological responses

Yang

Zhu

et al. 2021

Head & Neck

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Background Treatment of nasopharyngeal carcinoma (NPC) is evolving toward Intensity‐modulated radiotherapy (IMRT) era, which requires patient‐specific reestimation of survival outcomes in modern health care. Methods A total of 488 detectable pre‐treatment Epstein–Barr virus (EBV) DNA patients (stage II‐IVa) treated with induction chemotherapy (IC) and IMRT were examined (training set, n = 325; validation set, n = 163). Results Concurrent chemotherapy (CC) was still an independent prognosticator for overall survival (OS) and progression‐free survival (PFS). Both nomograms included age, T classification, N classification, post‐IC EBV DNA, and CC. Predictions correlated well with observed 3‐/5‐year OS and PFS. The concordance index was 0.776 (95% confidence interval (CI) 0.69–0.86) for OS and 0.742 (95% CI 0.65–0.83) for PFS in the validation cohort. The nomograms can successfully classify patients into low‐ and high‐risk groups. Conclusion The validated nomograms provided useful prediction of OS and PFS for detectable pre‐treatment EBV DNA patients with NPC in IMRT era.

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“…This conclusion confirmed several previous works [ 29 ]. Nonetheless, other published studies failed to reveal increased xerostomia in CCRT [ 30 ], because their datasets were moderate-to-severe xerostomia patients within 2 years after radiotherapy and gradual recovery of parotid glands function might attribute to unmeasured confounding. Recently, alternative concurrent chemotherapy regimens with mild toxicity for patients with LA-NPC have been reported [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

A nomogram for predicting late radiation-induced xerostomia among locoregionally advanced nasopharyngeal carcinoma in intensity modulated radiation therapy era

Yang

Xie

Zhang

et al. 2021

Aging

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Background: Dry mouth sensation cannot be improved completely even though parotids are spared correctly. Our purpose is to develop a nomogram to predict the moderate-to-severe late radiation xerostomia for patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) in intensity modulated radiation therapy (IMRT) / volumetric modulated arc radiotherapy (VMAT) era. Methods: A dataset of 311 patients was retrospectively collected between January 2010 and February 2013. The binary logistic regression was to estimate each factor’s prognostic value for development of moderate-to-severe patient-reported xerostomia at least 2 years (Xer2y) after completion of radiotherapy. Therefore, we can develop a nomogram according to binary logistic regression coefficients. This novel model was validated by bootstrapping analyses. Results: Contralateral Parotid mean dose (coMD<24.4Gy), VMAT (yes), and platinum-based concurrent chemoradiotherapy (no) were significantly related to patient-reported xerostomia at least 2 years (Xer2y) (all p < 0.001), and were included in the nomogram. Receiver operating characteristic (ROC) analysis revealed AUC (area under the ROC curve) with the value of 0.811 (0.710-0.912) of the nomogram, which was significantly higher than coMD 0.698 (0.560-0.840) from QUANTEC2010 (p<0.001). Calibration plots illustrated that the predicted Xer2y was close to the actual observation, and decision curve analyses (DCA) indicated valid positive net benefits. Conclusion: We developed a feasible nomogram to predict patient-rated Xer2y based on comprehensive individual data in patients with LA-NPC in the real world. The proposed model is able to facilitate the development of treatment plan and quality of life improvement.

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Ten-year outcomes of survival and toxicity for a phase III randomised trial of concurrent chemoradiotherapy versus radiotherapy alone in stage II nasopharyngeal carcinoma

Cited by 43 publications

References 18 publications

Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma

Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma

Nomograms for predicting survival outcomes in intensity‐modulated radiotherapy era of nasopharyngeal carcinoma: A study based on Epstein–Barr virus DNA biological responses

A nomogram for predicting late radiation-induced xerostomia among locoregionally advanced nasopharyngeal carcinoma in intensity modulated radiation therapy era

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