Open AccessPrognostic value and predictive threshold of tumor volume for patients with locally advanced nasopharyngeal carcinoma receiving intensity‐modulated radiotherapy
Author(s) -
He YuXiang,
Wang Ying,
Cao PengFei,
Shen Lin,
Zhao YaJie,
Zhang ZiJian,
Chen DengMing,
Yang TuBao,
Huang XinQiong,
Qin Zhou,
Dai YouYi,
Shen LiangFang
Publication year - 2016
Publication title -
cancer communications
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.119
H-Index - 53
ISSN - 2523-3548
DOI - 10.1186/s40880-016-0159-2
Subject(s) - nasopharyngeal carcinoma , medicine , receiver operating characteristic , radiation therapy , multivariate analysis , oncology , survival analysis , stage (stratigraphy) , nuclear medicine , carcinoma , predictive value , paleontology , biology
Background Gross target volume of primary tumor (GTV‐P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma (NPC), but it is unknown whether the same is true for locally advanced NPC patients treated with intensity‐modulated radiotherapy (IMRT). This study aimed to clarify the prognostic value of tumor volume for patient with locally advanced NPC receiving IMRT and to find a suitable cut‐off value of GTV‐P for prognosis prediction. Methods Clinical data of 358 patients with locally advanced NPC who received IMRT were reviewed. Receiver operating characteristic (ROC) curves were used to identify the cut‐off values of GTV‐P for the prediction of different endpoints [overall survival (OS), local relapse‐free survival (LRFS), distant metastasis‐free survival (DMFS), and disease‐free survival (DFS)] and to test the prognostic value of GTV‐P when compared with that of the American Joint Committee on Cancer T staging system. Results The 358 patients with locally advanced NPC were divided into two groups by the cut‐off value of GTV‐P as determined using ROC curves: 219 (61.2%) patients with GTV‐P ≤46.4 mL and 139 (38.8%) with GTV‐P >46.4 mL. The 3‐year OS, LRFS, DMFS, and DFS rates were all higher in patients with GTV‐P ≤46.4 mL than in those with GTV‐P > 46.4 mL (all P < 0.05). Multivariate analysis indicated that GTV‐P >46.4 mL was an independent unfavorable prognostic factor for patient survival. The ROC curve verified that the predictive ability of GTV‐P was superior to that of T category ( P < 0.001). The cut‐off values of GTV‐P for the prediction of OS, LRFS, DMFS, and DFS were 46.4, 57.9, 75.4 and 46.4 mL, respectively. Conclusion In patients with locally advanced NPC, GTV‐P >46.4 mL is an independent unfavorable prognostic indicator for survival after IMRT, with a prognostic value superior to that of T category.