The value of detailed MR imaging report of primary tumor and lymph nodes on prognostic nomograms for nasopharyngeal carcinoma after intensity-modulated radiotherapy. (February 2019)

• Record Type: Journal Article
• Authors: Wan, Yanzi; Tian, Li; Zhang, Guoyi; Xin, Hongyu; Li, Haojiang; Dong, Annan; Liang, Yiqin; Jing, Bingzhong; Zhou, Jian; Cui, Chunyan; Chen, Mingyuan; Sun, Ying; Xie, Chuanbo; Liu, Lizhi; Shao, Yuanzhi
• Is Part Of: Radiotherapy and oncology. Volume 131(2019)
• Page Start: 35
• Page End: 44
• Publication Date: 2019-02
• Subjects: NPC nasopharyngeal carcinoma -- MRI magnetic resonance imaging -- CT computed tomography -- IMRT intensity-modulated radiotherapy -- TNM tumor-node-metastasis -- AJCC American Joint Committee on Cancer -- UICC Union for Cancer Control -- OS overall survival -- PFS progress-free survival -- LASSO least absolute shrinkage and selection operator -- C-index concordance index -- SPSS statistical package for the social sciences -- EBV Epstein–Barr virus -- EBV_DNA_CN Epstein–Barr virus DNA copy number before treatment -- EA-IgA early antigen-immunoglobulin A -- VCA-IgA viral capsid antigen-immunoglobulin A -- WBC white blood cell count -- LYMPH lymphocyte count -- PLT platelet count -- HbsAg hepatitis B virus surface antigen -- LDH lactate dehydrogenase -- KPS Karnofsky's performance scale -- WHOHT World Health Organization histologic type -- TM therapeutic model -- TVP tensor veli palatini -- MPL musculus pterygoideus lateralis -- PS prestyloid space -- PVS prevertebral space -- BOSB base of sphenoid bone -- PNS paranasal sinus -- RPLN retropharyngeal lymph node -- PLN parotid lymph nodes -- ENS extranodal neoplastic spread -- NG nodal grouping -- CER contrast-enhancing rim -- CN central necrosis -- RDD research data deposit -- DFS disease-free survival -- DMFS distant metastasis-free survival -- CI confidence interval -- BMI body mass index -- hs-CRP high-sensitivity C-reactive protein -- NLR neutrophil–lymphocyte ratio -- GTV-P primary gross tumor volume; Nasopharyngeal neoplasms -- Magnetic resonance imaging -- Nomograms -- Survival analysis; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2018.11.001
• Languages: English
• ISSNs: 0167-8140

Abstract

Highlights: Detailed MR imaging report may provide more precise information on cancer extent and biology. MRI findings of primary tumor and regional lymph nodes can improve prognostic ability for NPC compared to TNM classification. The features that Age, EBV_DNA_CN, TVP, MPL, PS, PVS, BOSB, PNS, Ⅱ_laterality, RPLN_laterality, NG, ENS, CER and Nodal_number can effectively predict OS and PFS. An imaging reporting staging system for nasopharyngeal carcinoma (NI-RADS) will play an important role in improving the treatment effect and quality of life of nasopharyngeal cancer patients. Abstract: Purpose: To establish effective prognostic nomograms using clinical features and detailed magnetic resonance imaging (MRI) findings for primary tumor and regional lymph nodes after intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma. Method: The nomogram for overall survival (OS) was based on a retrospective study of 595 patients who underwent IMRT at Sun Yat-sen University Cancer Center from 2010 to 2012. The predictive accuracy and discriminative ability of our nomogram models were determined by concordance index and calibration curve, and were compared with the nomogram models combining clinical features with tumor-node-metastasis (TNM) classification. The results were validated using bootstrap resampling and a cohort study of 241 patients. The same data cohort was used to predict the progress-free survival (PFS) of nasopharyngeal carcinoma with 3:1 training cohort ( N = 558) and validation cohort ( N = 278). Results: The following factors were assembled into our prognostic survival nomogram models: Age, Epstein–Barr virus DNA copy number before treatment (EBV_DNA_CN), tensor veli palatini (TVP) involvement, musculus pterygoideus lateralis (MPL) involvement, prestyloid space (PS) involvement, prevertebral space (PVS) involvement, base of sphenoid bone (BOSB) involvement, paranasal sinus (PNS) involvement, the laterality of Ⅱ (Ⅱ_laterality), the laterality of retropharyngeal lymph node (RPLN_laterality), nodal grouping (NG), extranodal neoplastic spread (ENS), contrast-enhancing rim (CER) and Nodal_number. The calibration curves showed good agreement between nomogram-predicted and actual survival. Our nomogram models for OS and PFS, provided better results than the nomogram models combining clinical features with TNM classification. Results were further confirmed in the validation set. Conclusion: Detailed MRI findings of primary tumor and regional lymph nodes can improve the performance of prognostic nomograms for patients with nasopharyngeal carcinoma.