PREDICTING THE RESPONSE OF HEAD AND NECK CANCERS TO RADIATION-THERAPY WITH A MULTIVARIATE MODELING SYSTEM - AN ANALYSIS OF THE RTOG HEAD AND NECK REGISTRY
PREDICTING THE RESPONSE OF HEAD AND NECK CANCERS TO RADIATION-THERAPY WITH A MULTIVARIATE MODELING SYSTEM - AN ANALYSIS OF THE RTOG HEAD AND NECK REGISTRY
复制标题
DOI：
10.1016/0360-3016(84)90027-0
复制
发表时间：
1984-01-01
影响因子：
7
通讯作者：
MARCIAL, VA
中科院分区：
文献类型：
--
作者：
GRIFFIN, TW;PAJAK, TF;MARCIAL, VA
1977年至1980年间，原发性头颈癌患者（2066例）被纳入RTOG [放射治疗和肿瘤学组]头颈癌登记处。可评价的患者（997例）最初仅接受放射治疗。前瞻性记录肿瘤部位、T分期、N分期、组织学、浸润程度、分化程度、患者年龄、性别和Karnofsky评分。T分期（P < 0.001）、N分期（P = 0.007）、原发部位（P < 0.001）和初始Karnofsky评分（P < 0.001）是原发灶清除的独立预测因素。使用这些因素，构建多变量反应模型以预测原发性肿瘤反应。该模型的预测准确性被证明是高度可靠的，并通过比较每个自变量的预测与观察到的完全肿瘤清除率进行了测试。对于原发部位，预测的完全缓解数与观察到的完全缓解数分别为：口腔，预测值139.8与观察到的139;鼻咽，预测值51.8与观察到的51;口咽，预测值174.8与观察到的176;声门上喉，预测值314.4与观察到的318;声门喉，预测值314.4 vs.观察值318，下咽，预测值49.4 vs.观察值46。对于整个预测具有90%或更好的原发肿瘤完全缓解的患者组（包括T3和T4肿瘤），94%的患者在1年时原发部位保持初始完全缓解，87%的患者在2年时保持初始完全缓解。一个准确的多变量反应模型，如本文提出的1，应被证明是一个有用的工具，在选择适合单独放射治疗的头颈部癌症患者。
Patients (2066) with primary head and neck cancers were entered in the RTOG [Radiation Therapy and Oncology Group] Head and Neck Cancer Registry between 1977 and 1980. Evaluable patients (997) were treated initially with radiation therapy alone. Tumor site, T-stage, N-stage, histology, degree of infiltration, degree of differentiation, patient age, sex and Karnofsky performance score were all prospectively recorded. T-stage (P < 0.001), N-stage (P = 0.007), primary site (P < 0.001) and initial Karnofsky performance score (P < 0.001) were signigicant factors independently predictive of primary tumor clearance. Using these factors, a multivariate response model was constructed to predict primary tumor response. The predictive accuracy of the model proved to be highly reliable, and was tested by comparing the predicted vs. observed complete tumor clearance rates for each independent variable. For primary sites, the predicted number of complete responses vs. observed were: roal cavity, 139.8 predicted vs. 139 observed; nasopharynx, 51.8 predicted vs. 51 observed; oropharynx, 174.8 predicted vs. 176 observed, supraglottic larynx, 314.4 predicted vs. 318 observed; glottic larynx, 314.4 predicted vs. 318 observed and hypopharynx, 49.4 predicted vs. 46 observed. For the entire group of patients predicted to have a 90% or better complete primary tumor response (including T3 and T4 tumors), 94% remained in initial complete remission at the primary site at 1 yr and 87% at 2 yr. An accurate multivariate response model, such as the 1 presented in this paper, should prove to be a useful tool in selecting patients with head and neck cancers suitable for treatment with radiation therapy alone.