Development and external validation of nomograms predictive of response to radiation therapy and overall survival in nasopharyngeal cancer patients
Development and external validation of nomograms predictive of response to radiation therapy and overall survival in nasopharyngeal cancer patients
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DOI：
10.1016/j.ejca.2015.04.003
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发表时间：
2015-07-01
影响因子：
8.4
通讯作者：
Ahn, Yong Chan
中科院分区：
文献类型：
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作者：
Cho, Jae-Keun;Lee, Gil-Joon;Ahn, Yong Chan
前言：在接受相似治疗的同一时期的鼻咽癌患者中，临床结果差异很大。这表明目前的肿瘤-结节-转移分期系统需要改进。诺模图是一种有用的预测工具，它将单个变量整合到统计模型中，以预测感兴趣的结果。本研究旨在根据鼻咽癌患者的临床和病理特点设计预测诺模图。材料和方法：收集270例鼻咽癌患者的临床资料。通过单变量和多变量分析确定放疗反应和总生存期(OS)的预测因素，并建立预测诺模图。结果：除T分类外，还提取了预测RT反应的3个变量(年龄、组织学分级和N分类)和OS的4个预测变量(年龄、工作状态、吸烟状况和N分类)，以生成诺模图。结论：所设计的诺模图对个体患者的放疗和OS反应具有较高的预测性，有助于患者的个体化和个性化的咨询和护理。(C)2015爱思唯尔有限公司。保留所有权利。
Introduction: Large variability in the clinical outcomes has been observed among the nasopharyngeal cancer (NPC) patients with the same stage receiving similar treatment. This suggests that the current Tumour-Node-Metastasis staging systems need to be refined. The nomogram is a useful predictive tool that integrates individual variables into a statistical model to predict outcome of interest. This study was to design predictive nomograms based on the clinical and pathological features of patients with NPC.Materials and methods: Clinical data of 270 NPC patients who underwent definitive radiation therapy (RT) alone or concurrent with chemotherapy were collected. Factors predictive of response to RT and overall survival (OS) were determined by univariate and multivariate analyses, and predictive nomograms were created. Nomograms were validated externally by assessing discrimination and calibration using an independent data set (N = 122).Results: Three variables predictive of response to RT (age, histology classification and N classification) and four predictive of OS (age, performance status, smoking status and N classification), in addition to T classification, were extracted to generate the nomograms. The nomograms were validated externally, which showed perfect correlation with each other.Conclusion: The designed nomograms proved highly predictive of response to RT and OS in individual patients, and could facilitate individualised and personalised patients' counselling and care. (C) 2015 Elsevier Ltd. All rights reserved.