Development and prospective validation of a risk score model in guiding individualized concurrent chemoradiotherapy in stage II nasopharyngeal carcinoma in intensity‐modulated radiotherapy era
Abstract Purpose We aimed to develop and prospectively validate a risk score model to guide individualized concurrent chemoradiotherapy (CCRT) for patients with stage II nasopharyngeal carcinoma (NPC) in intensity‐modulated radiotherapy (IMRT) era. Materials and Methods In total, 1220 patients who r...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-02-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.4520 |
| _version_ | 1818297031969472512 |
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| author | Shan‐Shan Yang Ya‐Jun Pang Zhi‐Qiang Wang Bao‐Yu Zhang Zhi‐Qiao Liu En‐Ni Chen Pu‐Yun OuYang Fang‐Yun Xie |
| author_facet | Shan‐Shan Yang Ya‐Jun Pang Zhi‐Qiang Wang Bao‐Yu Zhang Zhi‐Qiao Liu En‐Ni Chen Pu‐Yun OuYang Fang‐Yun Xie |
| author_sort | Shan‐Shan Yang |
| collection | DOAJ |
| description | Abstract Purpose We aimed to develop and prospectively validate a risk score model to guide individualized concurrent chemoradiotherapy (CCRT) for patients with stage II nasopharyngeal carcinoma (NPC) in intensity‐modulated radiotherapy (IMRT) era. Materials and Methods In total, 1220 patients who received CCRT or IMRT alone were enrolled in this study, including a training cohort (n = 719), a validation cohort (n = 307), and a prospective test cohort (n = 194). Patients were stratified into different risk groups by a risk score model based on independent prognostic factors, which were developed in the training cohort. Survival rates were compared by the log‐rank test. The validation and prospective test cohorts were used for validation. Results Total tumor volume, Epstein–Barr virus DNA, and lactate dehydrogenase were independent risk factors for failure‐free survival (FFS, all p < 0.05). A risk score model based on these three risk factors was developed to classify patients into low‐risk group (no risk factor, n = 337) and high‐risk group (one or more factors, n = 382) in the training cohort. In the high‐risk group, CCRT had better survival rates than IMRT alone (5‐year FFS: 82.6% vs. 74.0%, p = 0.028). However, there was no survival difference between CCRT and IMRT alone either in the whole training cohort (p = 0.15) or in the low‐risk group (p = 0.15). The results were verified in the validation and prospective test cohorts. Conclusion A risk score model was developed and prospectively validated to precisely select high‐risk stage II NPC patients who can benefit from CCRT, and thus guided individualized treatment in IMRT era. |
| first_indexed | 2024-12-13T04:12:58Z |
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| id | doaj.art-a60b126958f44274afff637b1b5333bd |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-13T04:12:58Z |
| publishDate | 2022-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-a60b126958f44274afff637b1b5333bd2022-12-21T23:59:57ZengWileyCancer Medicine2045-76342022-02-011141109111810.1002/cam4.4520Development and prospective validation of a risk score model in guiding individualized concurrent chemoradiotherapy in stage II nasopharyngeal carcinoma in intensity‐modulated radiotherapy eraShan‐Shan Yang0Ya‐Jun Pang1Zhi‐Qiang Wang2Bao‐Yu Zhang3Zhi‐Qiao Liu4En‐Ni Chen5Pu‐Yun OuYang6Fang‐Yun Xie7Department of Radiation Oncology Sun Yat‐sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou ChinaCancer Center Affiliated Hospital of Guangdong Medical University Zhanjiang Guangdong Province ChinaDepartment of Radiotherapy Affiliated Dongguan People's Hospital of Southern Medical University Dongguan People's Hospital Dongguan Guangdong ChinaDepartment of Radiation Oncology Sun Yat‐sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou ChinaDepartment of Radiation Oncology Sun Yat‐sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou ChinaDepartment of Radiation Oncology Sun Yat‐sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou ChinaDepartment of Radiation Oncology Sun Yat‐sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou ChinaDepartment of Radiation Oncology Sun Yat‐sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou ChinaAbstract Purpose We aimed to develop and prospectively validate a risk score model to guide individualized concurrent chemoradiotherapy (CCRT) for patients with stage II nasopharyngeal carcinoma (NPC) in intensity‐modulated radiotherapy (IMRT) era. Materials and Methods In total, 1220 patients who received CCRT or IMRT alone were enrolled in this study, including a training cohort (n = 719), a validation cohort (n = 307), and a prospective test cohort (n = 194). Patients were stratified into different risk groups by a risk score model based on independent prognostic factors, which were developed in the training cohort. Survival rates were compared by the log‐rank test. The validation and prospective test cohorts were used for validation. Results Total tumor volume, Epstein–Barr virus DNA, and lactate dehydrogenase were independent risk factors for failure‐free survival (FFS, all p < 0.05). A risk score model based on these three risk factors was developed to classify patients into low‐risk group (no risk factor, n = 337) and high‐risk group (one or more factors, n = 382) in the training cohort. In the high‐risk group, CCRT had better survival rates than IMRT alone (5‐year FFS: 82.6% vs. 74.0%, p = 0.028). However, there was no survival difference between CCRT and IMRT alone either in the whole training cohort (p = 0.15) or in the low‐risk group (p = 0.15). The results were verified in the validation and prospective test cohorts. Conclusion A risk score model was developed and prospectively validated to precisely select high‐risk stage II NPC patients who can benefit from CCRT, and thus guided individualized treatment in IMRT era.https://doi.org/10.1002/cam4.4520concurrent chemoradiotherapyintensity‐modulated radiotherapynasopharyngeal carcinomatumor burden |
| spellingShingle | Shan‐Shan Yang Ya‐Jun Pang Zhi‐Qiang Wang Bao‐Yu Zhang Zhi‐Qiao Liu En‐Ni Chen Pu‐Yun OuYang Fang‐Yun Xie Development and prospective validation of a risk score model in guiding individualized concurrent chemoradiotherapy in stage II nasopharyngeal carcinoma in intensity‐modulated radiotherapy era Cancer Medicine concurrent chemoradiotherapy intensity‐modulated radiotherapy nasopharyngeal carcinoma tumor burden |
| title | Development and prospective validation of a risk score model in guiding individualized concurrent chemoradiotherapy in stage II nasopharyngeal carcinoma in intensity‐modulated radiotherapy era |
| title_full | Development and prospective validation of a risk score model in guiding individualized concurrent chemoradiotherapy in stage II nasopharyngeal carcinoma in intensity‐modulated radiotherapy era |
| title_fullStr | Development and prospective validation of a risk score model in guiding individualized concurrent chemoradiotherapy in stage II nasopharyngeal carcinoma in intensity‐modulated radiotherapy era |
| title_full_unstemmed | Development and prospective validation of a risk score model in guiding individualized concurrent chemoradiotherapy in stage II nasopharyngeal carcinoma in intensity‐modulated radiotherapy era |
| title_short | Development and prospective validation of a risk score model in guiding individualized concurrent chemoradiotherapy in stage II nasopharyngeal carcinoma in intensity‐modulated radiotherapy era |
| title_sort | development and prospective validation of a risk score model in guiding individualized concurrent chemoradiotherapy in stage ii nasopharyngeal carcinoma in intensity modulated radiotherapy era |
| topic | concurrent chemoradiotherapy intensity‐modulated radiotherapy nasopharyngeal carcinoma tumor burden |
| url | https://doi.org/10.1002/cam4.4520 |
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