Risk groups of laryngeal cancer treated with chemoradiation according to nomogram scores – A pooled analysis of RTOG 0129 and 0522. (May 2021)

• Record Type: Journal Article
• Authors: Awan, Musaddiq J.; Gittleman, Haley; Barnholtz-Sloan, Jill; Machtay, Mitchell; Nguyen-Tan, Phuc Felix; Rosenthal, David I.; Schultz, Christopher; Huth, Bradley J.; Thorstad, Wade L; Frank, Steven J.; Kim, Harold; Foote, Robert L.; Lango, Miriam N.; Shenouda, George; Suntharalingam, Mohan; Harris, Jonathan; Zhang, Qiang; Le, Quynh-Thu; Yao, Min
• Is Part Of: Oral oncology. Volume 116(2021)
• Publication Date: 2021-05
• Subjects: Larynx Cancer -- Nomograms -- Chemoradiation -- Prognostic Factors; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2021.105241
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: Patient selection for laryngeal preservation remains a significant clinical problem. We developed nomograms for larynx cancer outcomes using cooperative group trial data. These nomogram scores can stratify patients by both mortality and risk of recurrence. Abstract: Objectives: To develop nomograms predicting overall survival (OS), freedom from locoregional recurrence (FFLR), and freedom from distant metastasis (FFDM) for patients receiving chemoradiation for laryngeal squamous cell carcinoma (LSCC). Material and methods: Clinical and treatment data for patients with LSCC enrolled on NRG Oncology/RTOG 0129 and 0522 were extracted from the RTOG database. The dataset was partitioned into 70% training and 30% independent validation datasets. Significant predictors of OS, FFLR, and FFDM were obtained using univariate analysis on the training dataset. Nomograms were built using multivariate analysis with four a priori variables (age, gender, T-stage, and N-stage) and significant predictors from the univariate analyses. These nomograms were internally and externally validated using c-statistics (c) on the training and validation datasets, respectively. Results: The OS nomogram included age, gender, T stage, N stage, and number of cisplatin cycles. The FFLR nomogram included age, gender, T-stage, N-stage, and time-equivalent biologically effective dose. The FFDM nomogram included age, gender, N-stage, and number of cisplatin cycles. Internal validation of the OS nomogram, FFLR nomogram, and FFDM nomogram yielded c = 0.66, c = 0.66 and c = 0.73, respectively. External validation of these nomograms yielded c = 0.59, c = 0.70, and c = 0.73, respectively. Using nomogram score cutoffs, three risk groups were separated for each outcome. Conclusions: We have developed and validated easy-to-use nomograms for LSCC outcomes using prospective cooperative group trial data.