Prognostic value of total tumor volume in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy
Abstract Background Few studies have evaluated the prognostic value of total tumor volume (TTV), which reflects both the primary tumor volume and nodal tumor volume, in NPC. Furthermore, the relationship between TTV and survival remains unknown. The purpose of this study was to evaluate the prognost...
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| Language: | English |
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BMC
2017-07-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-017-3480-5 |
| _version_ | 1818943055838838784 |
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| author | Shao-Bo Liang Jian-Jian Teng Xue-Feng Hu Xing-Li Yang Min Luo Xiao-Na Fang Dong-Sheng Liu Yong Chen Li-Wu Fu |
| author_facet | Shao-Bo Liang Jian-Jian Teng Xue-Feng Hu Xing-Li Yang Min Luo Xiao-Na Fang Dong-Sheng Liu Yong Chen Li-Wu Fu |
| author_sort | Shao-Bo Liang |
| collection | DOAJ |
| description | Abstract Background Few studies have evaluated the prognostic value of total tumor volume (TTV), which reflects both the primary tumor volume and nodal tumor volume, in NPC. Furthermore, the relationship between TTV and survival remains unknown. The purpose of this study was to evaluate the prognostic value of TTV in patients with NPC treated with intensity-modulated radiation therapy (IMRT). Methods TTV was retrospectively assessed in 455 patients with newly diagnosed, non-metastatic NPC. All patients were treated using IMRT; 91.1% (288/316) of patients with stage III-IVb also received cisplatin-based chemotherapy. Receiver operating characteristic (ROC) curves were used to identify the optimal TTV cut-off point and examine the prognostic value of combined TTV with current clinical stage. Results Mean TTV was 11.1 cm3 (range, 0.3–27.9 cm3) in stage I, 22.5 cm3 (1.3–92.4 cm3) in stage II, 40.6 cm3 in stage III (3.2–129.2 cm3), and 77.5 cm3 in stage IVa-b (7.1–284.1 cm3). For all patients, the 4-year estimated FFS, OS, DMFS, and LRRFS rates for patients with a TTV ≤ 28 vs. > 28 cm3 were 93 vs. 71.4% (P < 0.001), 95.1 vs. 75.4% (P < 0.001), 94.5 vs. 79.4% (P < 0.001), and 96.2 vs. 88% (P = 0.001). TTV was an independent prognostic factor for FFS, OS, DMFS and LRRFS in all patients. In stage III-IVb, 4-year estimated FFS, OS, DMFS, and LRRFS for a TTV ≤28 vs. >28 cm3 were 88.9 vs. 70.5% (P = 0.001), 96.2 vs. 72.7% (P < 0.001), 91.2 vs. 78.3% (P = 0.008), and 93.8 vs. 87.6% (P = 0.063). TTV was an independent prognostic factor for FFS, OS and DMFS in stage III-IVb. Receiver operating characteristic (ROC) curve analysis curves revealed adding TTV to clinical stage had superior prognostic value for treatment failure compared to clinical stage alone (P = 0.016). Conclusions TTV is an important prognosticator for treatment outcome and significantly improves the prognostic value of the current staging system for patients with NPC treated with IMRT. |
| first_indexed | 2024-12-20T07:21:15Z |
| format | Article |
| id | doaj.art-288d94a727114254ab57c992e288f36a |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-20T07:21:15Z |
| publishDate | 2017-07-01 |
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| series | BMC Cancer |
| spelling | doaj.art-288d94a727114254ab57c992e288f36a2022-12-21T19:48:41ZengBMCBMC Cancer1471-24072017-07-0117111010.1186/s12885-017-3480-5Prognostic value of total tumor volume in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapyShao-Bo Liang0Jian-Jian Teng1Xue-Feng Hu2Xing-Li Yang3Min Luo4Xiao-Na Fang5Dong-Sheng Liu6Yong Chen7Li-Wu Fu8State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer MedicineDepartment of Radiation Oncology, Cancer Center, First People’s Hospital of Foshan Affiliated to Sun Yat-sen UniversityDepartment of Radiation Oncology, Cancer Center, First People’s Hospital of Foshan Affiliated to Sun Yat-sen UniversityState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer MedicineDepartment of Medical Statistics, First People’s Hospital of Foshan Affiliated to Sun Yat-sen UniversityState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer MedicineAbstract Background Few studies have evaluated the prognostic value of total tumor volume (TTV), which reflects both the primary tumor volume and nodal tumor volume, in NPC. Furthermore, the relationship between TTV and survival remains unknown. The purpose of this study was to evaluate the prognostic value of TTV in patients with NPC treated with intensity-modulated radiation therapy (IMRT). Methods TTV was retrospectively assessed in 455 patients with newly diagnosed, non-metastatic NPC. All patients were treated using IMRT; 91.1% (288/316) of patients with stage III-IVb also received cisplatin-based chemotherapy. Receiver operating characteristic (ROC) curves were used to identify the optimal TTV cut-off point and examine the prognostic value of combined TTV with current clinical stage. Results Mean TTV was 11.1 cm3 (range, 0.3–27.9 cm3) in stage I, 22.5 cm3 (1.3–92.4 cm3) in stage II, 40.6 cm3 in stage III (3.2–129.2 cm3), and 77.5 cm3 in stage IVa-b (7.1–284.1 cm3). For all patients, the 4-year estimated FFS, OS, DMFS, and LRRFS rates for patients with a TTV ≤ 28 vs. > 28 cm3 were 93 vs. 71.4% (P < 0.001), 95.1 vs. 75.4% (P < 0.001), 94.5 vs. 79.4% (P < 0.001), and 96.2 vs. 88% (P = 0.001). TTV was an independent prognostic factor for FFS, OS, DMFS and LRRFS in all patients. In stage III-IVb, 4-year estimated FFS, OS, DMFS, and LRRFS for a TTV ≤28 vs. >28 cm3 were 88.9 vs. 70.5% (P = 0.001), 96.2 vs. 72.7% (P < 0.001), 91.2 vs. 78.3% (P = 0.008), and 93.8 vs. 87.6% (P = 0.063). TTV was an independent prognostic factor for FFS, OS and DMFS in stage III-IVb. Receiver operating characteristic (ROC) curve analysis curves revealed adding TTV to clinical stage had superior prognostic value for treatment failure compared to clinical stage alone (P = 0.016). Conclusions TTV is an important prognosticator for treatment outcome and significantly improves the prognostic value of the current staging system for patients with NPC treated with IMRT.http://link.springer.com/article/10.1186/s12885-017-3480-5Nasopharyngeal carcinomaIntensity-modulated radiotherapyTumor volumeTreatment failureStaging system |
| spellingShingle | Shao-Bo Liang Jian-Jian Teng Xue-Feng Hu Xing-Li Yang Min Luo Xiao-Na Fang Dong-Sheng Liu Yong Chen Li-Wu Fu Prognostic value of total tumor volume in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy BMC Cancer Nasopharyngeal carcinoma Intensity-modulated radiotherapy Tumor volume Treatment failure Staging system |
| title | Prognostic value of total tumor volume in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy |
| title_full | Prognostic value of total tumor volume in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy |
| title_fullStr | Prognostic value of total tumor volume in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy |
| title_full_unstemmed | Prognostic value of total tumor volume in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy |
| title_short | Prognostic value of total tumor volume in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy |
| title_sort | prognostic value of total tumor volume in patients with nasopharyngeal carcinoma treated with intensity modulated radiotherapy |
| topic | Nasopharyngeal carcinoma Intensity-modulated radiotherapy Tumor volume Treatment failure Staging system |
| url | http://link.springer.com/article/10.1186/s12885-017-3480-5 |
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