Is primary tumor volume still a prognostic factor in intensity modulated radiation therapy for nasopharyngeal carcinoma?
Is primary tumor volume still a prognostic factor in intensity modulated radiation therapy for nasopharyngeal carcinoma?
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原发肿瘤体积是否仍是鼻咽癌调强放射治疗的预后因素？
DOI：
10.1016/j.radonc.2012.09.001
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发表时间：
2012-09-01
影响因子：
5.7
通讯作者：
Ma, Jun
中科院分区：
文献类型：
--
作者：
Guo, Rui;Sun, Ying;Ma, Jun
背景和目的：目的：探讨原发肿瘤体积（GTV-P）在鼻咽癌调强放疗（IMRT）中的预后价值。将样本随机分为训练集（n = 232）和测试集（n = 462）进行分析。计算受试者工作特征（ROC）曲线，确定GTV-P的临界值，并分析GTV-P与美国癌症联合委员会（AJCC）疾病分期的相关性。5年无病生存期（DES）、总生存期（OS）、GTV-P = 19 ml的NPC患者的局部无复发生存率（LRFS）和无远处转移生存率（DMFS）< 19 vs. >分别为94.9% vs.64.8%、97.0% vs.76.4%、98.2% vs.92.5%和97.1% vs.75.2%（均P < 0.05）。多因素分析显示GTV-P是独立的预后因素。结论：GTV-P可作为鼻咽癌调强放疗后预后的独立预测指标，可显著提高T分类的预测准确性。(c)2012爱思唯尔爱尔兰有限公司保留所有权利。放射治疗和肿瘤学104（2012）294-299
Background and purpose: To evaluate the prognostic value of gross primary tumor volume (GTV-P) in nasopharyngeal carcinoma (NPC) patients treated with intensity modulated radiotherapy (IMRT).Methods and materials: A total of 694 nonmetastatic and histologically proven NPC patients who underwent IMRT were retrospectively reviewed. Samples were split randomly into a training set (n = 232) and a test set (n = 462) to analysis. The receiver operating characteristic (ROC) curves were calculated to identify the cut-off point and test the prognostic validity of the GTV-P. The correlations between GTV-P and the American Joint Committee on Cancer (AJCC) disease stages were also analyzed.Results: The 5-year disease-free survival (DES), overall survival (OS), local relapse-free survival (LRFS) and distant metastasis-free survival (DMFS) rates for NPC patients with GTV-P < 19 vs. >= 19 ml were 94.9% vs. 64.8%, 97.0% vs. 76.4%, 98.2% vs. 92.5% and 97.1% vs. 75.2%, respectively (all P < 0.05) in all patients. Multivariate analysis indicated GTV-P was an independent prognostic factor. The ROC curve verified that the predictive ability of T classifications was improved when combined with GTV-P (P < 0.001).Conclusions: GTV-P is an independent prognostic indicator for treatment outcome after IMRT, and significantly improves the prognostic validity of T classifications in NPC. (c) 2012 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 104 (2012) 294-299