MRI-detected residual retropharyngeal lymph node after intensity-modulated radiotherapy in nasopharyngeal carcinoma: Prognostic value and a nomogram for the pretherapy prediction of it. (April 2020)

• Record Type: Journal Article
• Authors: Li, Wang-Zhong; Liu, Guo-Ying; Lin, Lan-Feng; Lv, Shu-Hui; Qiang, Meng-Yun; Lv, Xing; Wu, Yi-Shan; Liang, Hu; Ke, Liang-Ru; Wang, De-Ling; Yu, Ya-Hui; Qiu, Wen-Ze; Liu, Kui-Yuan; Guo, Xiang; Li, Jian-Peng; Zou, Yu-Jian; Xiang, Yan-Qun; Xia, Wei-Xiong
• Is Part Of: Radiotherapy and oncology. Volume 145(2020)
• Page Start: 101
• Page End: 108
• Publication Date: 2020-04
• Subjects: Nasopharyngeal carcinoma -- MRI -- Intensity-modulated radiotherapy -- Residual retropharyngeal lymph node -- Prognostic value -- Prediction nomogram; 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.2019.12.018
• Languages: English
• ISSNs: 0167-8140

Abstract

Highlights: MRI-detected residual retropharyngeal lymph node significantly affects NPC survival outcomes. We construct an easy-to-use tool for the pretherapy prediction of retropharyngeal lymph node. The pretherapy prediction of residual retropharyngeal lymph node may facilitate clinical decision making. Abstract: Background and purpose: To evaluate the prognostic value of MRI-detected residual retropharyngeal lymph node (RRLN) at three months after intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC) and second, to establish a nomogram for the pretherapy prediction of RRLN. Materials and methods: We included 1103 patients with NPC from two hospitals (Sun Yat-Sen University Cancer Center [SYSUCC, n = 901] and Dongguan People's Hospital [DGPH, n = 202]). We evaluated the prognostic value of RRLN using Cox regression model in SYSUCC cohort. We developed a nomogram for the pretherapy prediction of RRLN using logistic regression model in SYSUCC training cohort ( n = 645). We assessed the performance of this nomogram in an internal validation cohort (SYSUCC validation cohort, n = 256) and an external independent cohort (DGPH validation cohort, n = 202). Results: RRLN was an independent prognostic factor for OS (HR 2.08, 95% CI 1.32–3.29), DFS (HR 2.45, 95% CI 1.75–3.42), DMFS (HR 3.31, 95% CI 2.15–5.09), and LRRFS (HR 3.04, 95% CI 1.70–5.42). We developed a nomogram based on baseline Epstein–Barr virus DNA level and three RLN status-related features (including minimum axial diameter, extracapsular nodal spread, and laterality) that predicted an individual's risk of RRLN. Our nomogram showed good discrimination in the training cohort (C-index = 0.763). The favorable performance of this nomogram was confirmed in the internal and external validation cohorts. Conclusion: MRI-detected RRLN at three months after IMRT was an unfavorable prognostic factor for patients with NPC. We developed and validated an easy-to-use nomogram for the pretherapy prediction of RRLN.