A Nomogram for the Prognosis of Nasopharyngeal Carcinoma with MR Imaging-Detected Tumor Residue at the End of Intensity-Modulated Radiotherapy

Meng Xu, Chang Liu, Jing Lin Mi, Ren Sheng Wang Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Radiation Oncology Clinical Medical Research Center of Guangxi, Nanning 530021, Guangxi, People’s Republic of ChinaCorrespondence: Ren Sheng WangDe...

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Main Authors: Xu M, Liu C, Mi JL, Wang RS
Format: Article
Language:English
Published: Dove Medical Press 2020-05-01
Series:Cancer Management and Research
Subjects:
Online Access:https://www.dovepress.com/a-nomogram-for-the-prognosis-of-nasopharyngeal-carcinoma-with-mr-imagi-peer-reviewed-article-CMAR
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author Xu M
Liu C
Mi JL
Wang RS
author_facet Xu M
Liu C
Mi JL
Wang RS
author_sort Xu M
collection DOAJ
description Meng Xu, Chang Liu, Jing Lin Mi, Ren Sheng Wang Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Radiation Oncology Clinical Medical Research Center of Guangxi, Nanning 530021, Guangxi, People’s Republic of ChinaCorrespondence: Ren Sheng WangDepartment of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Radiation Oncology Clinical Medical Research Center of Guangxi, No. 6 Shuangyong Road, Nanning 530021, Guangxi, People’s Republic of ChinaTel +86-771-5359339Fax +86-771-5350031Email 13807806008@163.comObjective: This study set out to institute an effective nomogram to predict the prognosis of nasopharyngeal carcinoma (NPC) using magnetic resonance imaging (MRI)-detected residual tumor at the end of intensity-modulated radiotherapy (IMRT).Background: This study retrospectively analyzed the prognostic factors of NPC using MRI-detected residual tumor at the end of IMRT, in order to individualize the treatment of patients with poor prognosis as early as possible.Methods: Overall, 162 NPC patients with local or regional residual tumor at the end of IMRT were retrospectively analyzed. Based on multivariate Cox regression analysis using the backward stepwise method, a nomogram was generated to predict the prognosis of these patients. Identification, calibration, clinical applicability and reproducibility were evaluated by C-index, time-dependent AUC, calibration curve and bootstrap verification. According to the best cut-off value of total score of prognoses calculated by X-tile software, all patients were separated into either low-risk or high-risk group.Results: The nomogram identified age, chemotherapy, N stage, lymph nodes necrosis are significant predictors of prognosis. The AUC of the prediction model is 0.754, and the consistency index is 0.724 (95% confidence interval is 0.659– 0.788). The model has good discrimination ability. Through bootstrapping test, the consistency index, corrected slope was 0.723, 0.861, respectively. The calibration slope of predicting 3-year and 5-year overall survival was 1.006 and 1.071, respectively. The calibration curve showed satisfactory calibration effect and good net benefit. The best cut-off value of total score of prognoses calculated by X-tile software was 149.1. Kaplan–Meier survival curve showed that OS and DMFS in the high-risk group were substantially reduced compared to those in the low-risk group.Conclusion: We constructed and validated a new nomogram to help clinicians understand the prognosis of NPC patients with residue at the end of IMRT. With an estimate of the individual risk, clinicians can start treatment decisions as early as possible for high-risk patients with poor prognosis.Keywords: nasopharyngeal carcinoma, residue, IMRT
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spelling doaj.art-4a2994af299945a79bd52dd80661fa212022-12-21T19:08:55ZengDove Medical PressCancer Management and Research1179-13222020-05-01Volume 123835384454058A Nomogram for the Prognosis of Nasopharyngeal Carcinoma with MR Imaging-Detected Tumor Residue at the End of Intensity-Modulated RadiotherapyXu MLiu CMi JLWang RSMeng Xu, Chang Liu, Jing Lin Mi, Ren Sheng Wang Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Radiation Oncology Clinical Medical Research Center of Guangxi, Nanning 530021, Guangxi, People’s Republic of ChinaCorrespondence: Ren Sheng WangDepartment of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Radiation Oncology Clinical Medical Research Center of Guangxi, No. 6 Shuangyong Road, Nanning 530021, Guangxi, People’s Republic of ChinaTel +86-771-5359339Fax +86-771-5350031Email 13807806008@163.comObjective: This study set out to institute an effective nomogram to predict the prognosis of nasopharyngeal carcinoma (NPC) using magnetic resonance imaging (MRI)-detected residual tumor at the end of intensity-modulated radiotherapy (IMRT).Background: This study retrospectively analyzed the prognostic factors of NPC using MRI-detected residual tumor at the end of IMRT, in order to individualize the treatment of patients with poor prognosis as early as possible.Methods: Overall, 162 NPC patients with local or regional residual tumor at the end of IMRT were retrospectively analyzed. Based on multivariate Cox regression analysis using the backward stepwise method, a nomogram was generated to predict the prognosis of these patients. Identification, calibration, clinical applicability and reproducibility were evaluated by C-index, time-dependent AUC, calibration curve and bootstrap verification. According to the best cut-off value of total score of prognoses calculated by X-tile software, all patients were separated into either low-risk or high-risk group.Results: The nomogram identified age, chemotherapy, N stage, lymph nodes necrosis are significant predictors of prognosis. The AUC of the prediction model is 0.754, and the consistency index is 0.724 (95% confidence interval is 0.659– 0.788). The model has good discrimination ability. Through bootstrapping test, the consistency index, corrected slope was 0.723, 0.861, respectively. The calibration slope of predicting 3-year and 5-year overall survival was 1.006 and 1.071, respectively. The calibration curve showed satisfactory calibration effect and good net benefit. The best cut-off value of total score of prognoses calculated by X-tile software was 149.1. Kaplan–Meier survival curve showed that OS and DMFS in the high-risk group were substantially reduced compared to those in the low-risk group.Conclusion: We constructed and validated a new nomogram to help clinicians understand the prognosis of NPC patients with residue at the end of IMRT. With an estimate of the individual risk, clinicians can start treatment decisions as early as possible for high-risk patients with poor prognosis.Keywords: nasopharyngeal carcinoma, residue, IMRThttps://www.dovepress.com/a-nomogram-for-the-prognosis-of-nasopharyngeal-carcinoma-with-mr-imagi-peer-reviewed-article-CMARnasopharyngeal carcinomaresidueimrt
spellingShingle Xu M
Liu C
Mi JL
Wang RS
A Nomogram for the Prognosis of Nasopharyngeal Carcinoma with MR Imaging-Detected Tumor Residue at the End of Intensity-Modulated Radiotherapy
Cancer Management and Research
nasopharyngeal carcinoma
residue
imrt
title A Nomogram for the Prognosis of Nasopharyngeal Carcinoma with MR Imaging-Detected Tumor Residue at the End of Intensity-Modulated Radiotherapy
title_full A Nomogram for the Prognosis of Nasopharyngeal Carcinoma with MR Imaging-Detected Tumor Residue at the End of Intensity-Modulated Radiotherapy
title_fullStr A Nomogram for the Prognosis of Nasopharyngeal Carcinoma with MR Imaging-Detected Tumor Residue at the End of Intensity-Modulated Radiotherapy
title_full_unstemmed A Nomogram for the Prognosis of Nasopharyngeal Carcinoma with MR Imaging-Detected Tumor Residue at the End of Intensity-Modulated Radiotherapy
title_short A Nomogram for the Prognosis of Nasopharyngeal Carcinoma with MR Imaging-Detected Tumor Residue at the End of Intensity-Modulated Radiotherapy
title_sort nomogram for the prognosis of nasopharyngeal carcinoma with mr imaging detected tumor residue at the end of intensity modulated radiotherapy
topic nasopharyngeal carcinoma
residue
imrt
url https://www.dovepress.com/a-nomogram-for-the-prognosis-of-nasopharyngeal-carcinoma-with-mr-imagi-peer-reviewed-article-CMAR
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