Development and Internal Validation of a Prediction Model for Nasopharyngeal Carcinoma: Using BMI and Inflammatory Response for Deciding Sequence of Chemotherapy
PURPOSEConcurrent chemoradiotherapy followed by adjuvant chemotherapy (CRT-AC) and induction chemotherapy followed by concurrent chemoradiotherapy (IC-CRT) are among the best treatments in nasopharyngeal carcinoma (NPC). This study aimed to develop a model for deciding the sequence of chemotherapy i...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2024-02-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO.23.00119 |
| _version_ | 1797305397771501568 |
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| author | Jiraporn Setakornnukul Janjira Petsuksiri Panid Chaysiri Pongwut Danchaivijitr Nuttapong Ngamphaiboon Kullathorn Thephamongkhol |
| author_facet | Jiraporn Setakornnukul Janjira Petsuksiri Panid Chaysiri Pongwut Danchaivijitr Nuttapong Ngamphaiboon Kullathorn Thephamongkhol |
| author_sort | Jiraporn Setakornnukul |
| collection | DOAJ |
| description | PURPOSEConcurrent chemoradiotherapy followed by adjuvant chemotherapy (CRT-AC) and induction chemotherapy followed by concurrent chemoradiotherapy (IC-CRT) are among the best treatments in nasopharyngeal carcinoma (NPC). This study aimed to develop a model for deciding the sequence of chemotherapy in NPC.METHODSData were separated into two cohorts. The CRT-AC cohort had 295 patients, while the IC-CRT cohort had 112. The predictors were standard factors with BMI and neutrophil-lymphocyte ratio (NLR) to predict overall survival (OS). A flexible parametric survival model was used.RESULTSA total of 132 (44.7%) and 72 patients (64.3%) died in the CRT-AC and IC-CRT cohorts, respectively. The predictors in the final models were age, sex, T, N, NLR, and BMI. The models of OS for CRT-AC and IC-CRT had concordance indices of 0.689 and 0.712, respectively, with good calibration curves. When changing the burden of disease along with NLR and BMI, we found that CRT-AC was not significantly different OS from IC-CRT when low NLR (<3) and high burden of disease (T3N3). By contrast, CRT-AC was remarkably more effective when there were high levels of NLR (≥3) and BMI (≥25) with any burden of disease (anyT anyN).CONCLUSIONWith additional BMI and NLR in model, it could be easier to decide between CRT-AC and IC-CRT in countries with limited health care resources. |
| first_indexed | 2024-03-08T00:25:21Z |
| format | Article |
| id | doaj.art-ec78e900a60c4544b39263480acd55f7 |
| institution | Directory Open Access Journal |
| issn | 2687-8941 |
| language | English |
| last_indexed | 2024-03-08T00:25:21Z |
| publishDate | 2024-02-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj.art-ec78e900a60c4544b39263480acd55f72024-02-15T20:59:19ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412024-02-011010.1200/GO.23.00119Development and Internal Validation of a Prediction Model for Nasopharyngeal Carcinoma: Using BMI and Inflammatory Response for Deciding Sequence of ChemotherapyJiraporn Setakornnukul0Janjira Petsuksiri1Panid Chaysiri2Pongwut Danchaivijitr3Nuttapong Ngamphaiboon4Kullathorn Thephamongkhol5Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Radiation Oncology, Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Radiation Oncology, Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Medical Oncology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Medical Oncology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDivision of Radiation Oncology, Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandPURPOSEConcurrent chemoradiotherapy followed by adjuvant chemotherapy (CRT-AC) and induction chemotherapy followed by concurrent chemoradiotherapy (IC-CRT) are among the best treatments in nasopharyngeal carcinoma (NPC). This study aimed to develop a model for deciding the sequence of chemotherapy in NPC.METHODSData were separated into two cohorts. The CRT-AC cohort had 295 patients, while the IC-CRT cohort had 112. The predictors were standard factors with BMI and neutrophil-lymphocyte ratio (NLR) to predict overall survival (OS). A flexible parametric survival model was used.RESULTSA total of 132 (44.7%) and 72 patients (64.3%) died in the CRT-AC and IC-CRT cohorts, respectively. The predictors in the final models were age, sex, T, N, NLR, and BMI. The models of OS for CRT-AC and IC-CRT had concordance indices of 0.689 and 0.712, respectively, with good calibration curves. When changing the burden of disease along with NLR and BMI, we found that CRT-AC was not significantly different OS from IC-CRT when low NLR (<3) and high burden of disease (T3N3). By contrast, CRT-AC was remarkably more effective when there were high levels of NLR (≥3) and BMI (≥25) with any burden of disease (anyT anyN).CONCLUSIONWith additional BMI and NLR in model, it could be easier to decide between CRT-AC and IC-CRT in countries with limited health care resources.https://ascopubs.org/doi/10.1200/GO.23.00119 |
| spellingShingle | Jiraporn Setakornnukul Janjira Petsuksiri Panid Chaysiri Pongwut Danchaivijitr Nuttapong Ngamphaiboon Kullathorn Thephamongkhol Development and Internal Validation of a Prediction Model for Nasopharyngeal Carcinoma: Using BMI and Inflammatory Response for Deciding Sequence of Chemotherapy JCO Global Oncology |
| title | Development and Internal Validation of a Prediction Model for Nasopharyngeal Carcinoma: Using BMI and Inflammatory Response for Deciding Sequence of Chemotherapy |
| title_full | Development and Internal Validation of a Prediction Model for Nasopharyngeal Carcinoma: Using BMI and Inflammatory Response for Deciding Sequence of Chemotherapy |
| title_fullStr | Development and Internal Validation of a Prediction Model for Nasopharyngeal Carcinoma: Using BMI and Inflammatory Response for Deciding Sequence of Chemotherapy |
| title_full_unstemmed | Development and Internal Validation of a Prediction Model for Nasopharyngeal Carcinoma: Using BMI and Inflammatory Response for Deciding Sequence of Chemotherapy |
| title_short | Development and Internal Validation of a Prediction Model for Nasopharyngeal Carcinoma: Using BMI and Inflammatory Response for Deciding Sequence of Chemotherapy |
| title_sort | development and internal validation of a prediction model for nasopharyngeal carcinoma using bmi and inflammatory response for deciding sequence of chemotherapy |
| url | https://ascopubs.org/doi/10.1200/GO.23.00119 |
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