Prognostic analysis of patients with locally advanced nasopharyngeal carcinoma following intensity modulated radiation therapy

Zhao, Yajie; Shen, Lin; Huang, Xinqiong; He, Yuxiang; Fu, Jun; Qian, Yingyi; Li, Shan; Zhao, Na; Shen, Liangfang

doi:10.3892/ol.2018.7850

Cited by 4 publications

(4 citation statements)

References 43 publications

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“…In this study, we found that paranasal sinus invasion and cervical lymphatic metastasis were independent negative prognostic factors for OS, PFS, and DMFS and that GTVnx-residual was an independent negative prognostic factor for OS. Our previous studies confirmed that the distance between the primary tumor and brain stem and residual nasopharyngeal carcinoma after chemotherapy are important factors that affect the survival of NPC patients (17,18). Here, we found that the OS, PFS, DMFS, and LRFS did not differ between patients with paranasal sinus invasion and T3 disease and those with T4.…”

Section: Discussionsupporting

confidence: 84%

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Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving Radiotherapy

Zhao

Zhou

et al. 2020

Front. Oncol.

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In this study, we explored the association between paranasal sinus invasion and prognosis in patients with advanced nasopharyngeal carcinoma (NPC, (T3/T4N0-3M0), and we assessed the possibility of considering paranasal sinus invasion a T category in the 8th edition of the American Joint Committee on Cancer staging system. We enrolled 352 NPC patients who received intensity-modulated radiotherapy between 2008 and 2012. Clinical characteristics and follow-up data were collected. The incidence of paranasal sinus invasion was 36.4% (128 of 352 patients). Multivariate cox regression analysis indicated that paranasal sinus invasion and cervical lymphatic metastasis were independent negative prognostic factors for overall survival (OS, P=0.024, P=0.012), progression-free survival (PFS, P=0.007, P=0.007), and distant metastasis-free survival (DMFS, P=0.001, P=0.000). The gross tumor volume of the nasopharynx was an independent negative prognostic factor for OS (P=0.013). Cox regression analysis indicated that there were no significant differences in OS, PFS, DMFS, or local relapsefree survival (LRFS) between NPC patients with T4 stage disease and those with T3 and paranasal sinus invasion (P>0.05). The updated T + N staging system slightly improved the prediction of LRFS (0.649, 95% CI: 0.553-0.745) in NPC patients compared to the AJCC system (0.640, 95% CI: 0.545-0.736; P=0.023). Paranasal sinus invasion is independently associated with a poor prognosis in NPC patients. Thus, we recommend that the AJCC staging system upgrade paranasal sinus invasion to the T4 classification.

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Section: Discussionsupporting

confidence: 84%

“…The c-index was also calculated using R 3.6.0 software. The P -value of the c-index was obtained using the two-tailed paired t -test, calculated according to the rcorrp.cens function in the Hmisc package ( 16 , 17 ). P <0.05 was considered statistically significant.…”

Section: Methodsmentioning

confidence: 99%

Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving Radiotherapy

Zhao

Zhou

et al. 2020

Front. Oncol.

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“…1,2 For non-metastatic NPC, the 5-year overall survival (OS) has been reported to be between 62% and 90%. [3][4][5][6] The tumor-node-metastasis (TNM) staging system is the most widely used system for predicting the survival of NPC patients; however, due to the intrinsic heterogeneity of tumor cells, and because intratumor microenvironments are not considered in the TNM staging system, personalized biomarkers for the pathogenesis or progression of NPC are needed to predict patient survival more accurately.…”

Section: Introductionmentioning

confidence: 99%

Influence of CDK5 Regulatory Subunit-Associated Protein 1-Like 1 Expression on the Survival of Patients with Non-Metastatic Nasopharyngeal Carcinoma

Li¹,

Zhao²

2021

CMAR

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Background The aim of this study was to investigate the influence of CDK5 regulatory subunit-associated protein 1-like 1 (CDKAL1) expression on the survival of nasopharyngeal carcinoma (NPC) patients. Methods A total of 140 non-metastatic NPC patients were retrospectively analyzed. The expression of CDKAL1 was detected by immunohistochemistry. Results The CDKAL1-negative group exhibited better overall survival (OS) according to Kaplan–Meier curve analysis ( p = 0.006), with 5-year OS rates for the CDKAL1-negative and -positive groups of 89.7% and 70.2%, respectively. The CDKAL1-negative group also exhibited a tendency toward a better progression-free survival (PFS) rate. Multivariate analysis showed that CDKAL1 expression was independently associated with both OS ( p = 0.002) and PFS ( p = 0.043). Conclusion CDKAL1 expression is an independent negative predictor of patient survival in non-metastatic NPC.

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“…Still, nasopharyngeal carcinomas are commonly diagnosed in Asia, especially in China [the crude incidence rate was 3.26/100,000 ( 2 )]. Radiotherapy remains the standard treatment for these generally radiosensitive tumors and current estimates of 5-year overall survival after radiotherapy range from 66% to 83% ( 3 ). Given these promising survival rates, oncologists increasingly have focused on the quality of life of their patients.…”

Section: Introductionmentioning

confidence: 99%

A predictive model of radiation-related fibrosis based on the radiomic features of magnetic resonance imaging and computed tomography

Wang¹,

Liu²,

Zhao³

et al. 2020

Transl Cancer Res TCR

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Background: To establish a predictive model for the fibrotic level of neck muscles after radiotherapy by using radiomic features extracted from the magnetic resonance imaging (MRI) before and after radiotherapy and planning computed tomography (CT) in nasopharyngeal carcinoma patients.Methods: A total of one hundred and eighty-six patients were finally enrolled in this study. According to the specific standard, all patients were divided into three different fibrosis groups. Regions of interests (ROI), including sternocleidomastoids (SCMs), trapezius (T), levator scapulae (LS), and scalenus muscles (S), were delineated manually and used for features extraction on IBEX. XGBoost, a machine learning algorithm, was used for the establishment of the prediction model. First, the patients were divided into training cohort (80%) and testing cohort (20%) randomly. Then the image features of CT or delta changes calculated from preand post-radiotherapy MRI images on each cohort constituted training and testing datasets. Then, based on the training dataset, a well-trained prediction model was produced. We used five-fold cross-validation to validate the predictive models. Afterward, the model performance was assessed on the 'testing' set and reported in terms of area under the receiver operating characteristic curve (AUC) under five scenarios: (I) only T1 sequence, (II) only T2 sequence, (III) only T1 post-contrast (T1 + C) sequence, (IV) Combination of all MRI sequences, (V) only CT.Results: Most of the patients enrolled are male (73.1%), mean age was 47 years, receiving concurrent chemo-radiotherapy as the primary treatment (90.9%). By the end of the final follow-up, most of the patients were rated as mild fibrosis (60.8%). We found the prediction model based on the CT image features outperform all MRI features with an AUC of 0.69 and accuracy of 0.65. Contrarily, the model based on features from all MRI sequence showed lower AUC less than 0.5 and lower accuracy less than 0.6. Conclusions:The prediction model based on CT radiomics features has better performance in the prediction of the grade of post-radiotherapy neck fibrosis. This might help guide radiotherapy treatment planning to achieve a better quality of life.

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Prognostic analysis of patients with locally advanced nasopharyngeal carcinoma following intensity modulated radiation therapy

Cited by 4 publications

References 43 publications

Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving Radiotherapy

Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving Radiotherapy

Influence of CDK5 Regulatory Subunit-Associated Protein 1-Like 1 Expression on the Survival of Patients with Non-Metastatic Nasopharyngeal Carcinoma

A predictive model of radiation-related fibrosis based on the radiomic features of magnetic resonance imaging and computed tomography

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