Development and Validation of Web-Based Nomograms to Precisely Predict Survival Outcomes of Non-metastatic Nasopharyngeal Carcinoma in an Endemic Area

Yao, Ji‐Jin; Lin, Li; Gao, Tian-Sheng; Zhang, Wangjian; Lawrence, Wayne R.; Ma, Jingfei; Sun, Ying

doi:10.4143/crt.2020.899

Cited by 16 publications

(16 citation statements)

References 31 publications

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“…These web-based nomograms can be used to help physicians formulate personalized treatment and follow-up plans in patients with LUAD and bone metastasis. 33 …”

Section: Discussionmentioning

confidence: 99%

A predictive web-based nomogram for the early death of patients with lung adenocarcinoma and bone metastasis: a population-based study

Wei

Cao

et al. 2021

J Int Med Res

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Objective To identify risk factors and develop predictive web-based nomograms for the early death of patients with bone metastasis of lung adenocarcinoma (LUAD). Methods Patients in the Surveillance, Epidemiology, and End Results database diagnosed with bone metastasis of LUAD between 2010 and 2016 were included and randomly divided into training and validation sets. Early death-related risk factors (survival time ≤7 months) were evaluated by logistic regression. Two predictive nomograms were established and validated by calibration curves, receiver operating characteristic curves, and decision curve analysis. Results A total of 9189 patients (56.59%) died from all causes within 7 months of being diagnosed, including 8585 patients (56.67%) who died from cancer-specific causes. Age >65 years, sex (men), T stage (T3 and T4), N stage (N2 and N3), brain metastasis, and liver metastasis were risk factors for all-cause and cancer-specific early death. The area under the curves of the nomograms for all-cause and cancer-specific early death prediction were 0.754 and 0.753 (training set) and 0.747 and 0.754 (validation set), respectively. Further analysis showed that the two nomograms performed well. Conclusions Our two web-based nomograms for all-cause and cancer-specific early death provide valuable tools for predicting early death in these patients.

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“…These web-based nomograms can be used to help physicians formulate personalized treatment and follow-up plans in patients with LUAD and bone metastasis. 33 …”

Section: Discussionmentioning

confidence: 99%

A predictive web-based nomogram for the early death of patients with lung adenocarcinoma and bone metastasis: a population-based study

Wei

Cao

et al. 2021

J Int Med Res

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“…Nomograms were created using the rms package within R, and gender was included into the nomogram given the importance of gender in clinical decision-making. 3 The concordance index (C-index) was utilized to estimate bias-correction or overfitting within the model. P < 0.05 were categorized as significant, and all statistical assessments were two-sided.…”

Section: Methodsmentioning

confidence: 99%

“… 1 Unfortunately, more than 70% of patients with NPC are categorized with locoregionally advanced disease at initial diagnosis. 2 , 3 Despite the use of intensity-modulated radiotherapy and chemotherapy, outcomes for patients with advanced disease still remain unsatisfactory, with 30–50% of patients suffering from disease relapse post treatment. 3 It is challenging for clinicians to manage locoregionally advanced NPC (LANPC).…”

Section: Introductionmentioning

confidence: 99%

“… 2 , 3 Despite the use of intensity-modulated radiotherapy and chemotherapy, outcomes for patients with advanced disease still remain unsatisfactory, with 30–50% of patients suffering from disease relapse post treatment. 3 It is challenging for clinicians to manage locoregionally advanced NPC (LANPC). The standard treatment for LANPC is concurrent chemoradiotherapy (CCRT).…”

Section: Introductionmentioning

confidence: 99%

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The Role of Pretreatment 18F-FDG PET/CT for Early Prediction of Neoadjuvant Chemotherapy Response in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma

Yao¹,

Wang²,

Lin³

et al. 2021

DDDT

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Introduction To evaluate the role of maximal standardized uptake values (SUVmax) and total lesion glycolysis (TLG) from serial 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for early prediction of neoadjuvant chemotherapy (NAC) response in locoregionally advanced nasopharyngeal carcinoma (LANPC). Methods A total of 121 LANPC patients who completed pretreatment 18 F-FDG PET/CT between June 2017 and July 2020 were retrospectively included. The median age of all the participants was 50 years old (range: 19–74 years), with 94 (77.7%) males and 27 (22.3%) females. The SUVmax from the primary tumor site (SUVmax-PT) and the total lesion glycolysis from the primary tumor site (TLG-PT) were recorded. Tumor response was calculated according to the Response Evaluation Criteria in Solid Tumor (RECIST) 1.1 Criteria at two-week post-secondary NAC cycle. Patients who achieved an objectively partial or full reaction after two cycles of NAC were defined as ‘responders’, and patients who obtained stability or progression were classified as ‘non-responders’. Results After two cycles of NAC, 96 patients were categorized as “responders” and 25 patients as “non-responders”. The optimal thresholds of the SUVmax-PT were 11.8 and 38.5 for the TLG-PT. Non-responders were significantly associated with high SUVmax-PT (HR, 3.49; 95% CI, 1.17–10.36; p = 0.024) and TLG-PT (HR, 4.45; 95% CI, 1.44–13.78; p = 0.010) in multivariate analysis. Recursive partitioning analysis (RPA) categorized patients into three prognostic groups based on SUVmax-PT and TLG-PT: high-response group, intermediate-response group, and low-response group, with corresponding favorable response rates of 94%, 80%, and 55%, respectively. Moreover, a nomogram was created based on metabolic parameters that precisely projected an individual’s response of NAC (C-index, 0.787; 95% CI, 0.533–1.000). Conclusion Pretreatment 18 F-FDG PET/CT to measure SUVmax-PT and TLG-PT could be a useful non-invasive method for early indication of NAC efficacy. The nomogram based on PET/CT parameters may potentially provide direction for treatment decisions based on NAC levels.

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“… 2 , 3 , 4 Despite the application of intensity‐modulated radiotherapy (IMRT) and systemic chemotherapy, management of LANPC remains a challenge, as nearly 30% of patients develop disease progression after treatment. 4 The results from some well‐designed randomized controlled trials indicated that using induction chemotherapy (IC) before CCRT provided survival benefits for LANPC patients. 5 , 6 , 7 , 8 Guidelines of the NCCN and CSCO both strongly recommend IC combined with CCRT for LANPC, 9 , 10 which has promoted its widespread use in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Individualized number of induction chemotherapy cycles for locoregionally advanced nasopharyngeal carcinoma patients based on early tumor response

et al. 2022

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Background The optimal number of cycles of induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (LANPC) is unclear. We aimed to combine the tumor response during IC and tumor stage to individualize the number of IC cycles. Methods Totally, 498 LANPC patients who received IC plus CCRT between 2014 and 2018 were reviewed. Tumor response during IC was used to stratify patients with different risks. All patients were classified into those who received two cycles of IC and those who were treated with three cycles. Propensity score matching methods were performed to compare the treatment efficiency. Results After two cycles of IC, 340/498 (68.3%) cases showed complete tumor response (CR)/partial response (PR) and 158 (31.7%) achieved stable disease (SD)/disease progression (PD). Unfavorable responders (SD/PD) exhibited poor survival outcomes. The three‐cycle IC regimen was correlated with better OS and PFS than the two‐cycle regimen for N2‐3 patients in the CR/PR group. However, the use of different IC cycle strategies achieved similar survival outcomes for SD/PD or N0‐1 patients. The incidences of acute toxicities were higher in the IC = 3 group. Conclusions Tumor response during IC could be a powerful predictor of LANPC and could be used to guide the individualized number of IC cycles. A three‐cycle IC regimen seemed to be preferable for N2‐3 patients who received CR/PR during IC. However, an additional cycle of IC could not benefit N0‐1 or SD/PD patients, and the optimal treatment strategies for these patients require further consideration.

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Development and Validation of Web-Based Nomograms to Precisely Predict Survival Outcomes of Non-metastatic Nasopharyngeal Carcinoma in an Endemic Area

Cited by 16 publications

References 31 publications

A predictive web-based nomogram for the early death of patients with lung adenocarcinoma and bone metastasis: a population-based study

A predictive web-based nomogram for the early death of patients with lung adenocarcinoma and bone metastasis: a population-based study

The Role of Pretreatment 18F-FDG PET/CT for Early Prediction of Neoadjuvant Chemotherapy Response in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma

Individualized number of induction chemotherapy cycles for locoregionally advanced nasopharyngeal carcinoma patients based on early tumor response

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