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Nomogram for distant metastasis-free survival in patients with locoregionally advanced nasopharyngeal carcinoma

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Abstract

Objective

To develop and validate a nomogram to predict distant metastasis-free survival of patients with locoregionally advanced nasopharyngeal carcinoma.

Methods

We collected the total clinical data of 820 nasopharyngeal carcinoma (NPC) patients, of whom 482 formed the training cohort from one hospital and 328 made up the validation cohort from another hospital. By analyzing the prognosis of all patients after intensity-modulated radiotherapy by univariate and multivariate Cox regression models, a nomogram related to DMFS was created in the training cohort. The discriminatory and calibration power of the nomogram was successively assessed in the training and validation cohorts by the C‑index and calibration curve. The predictive ability for 3‑year DMFS was compared between the nomogram and TNM stage using ROC curves. Patients were divided into different risk groups based on scores calculated from the nomogram.

Results

Age, lymph node gross tumor volume (GTVnd), and gross tumor volume of the nasopharynx (GTVnx) were the factors included in the nomogram. The C‑index of the nomogram was 0.721 in the training cohort and 0.750 in the validation cohort. The calibration curves were satisfactory. Patients in the high-risk group were more likely to develop metastases.

Conclusion

A nomogram incorporating age, GTVnd, and GTVnx showed good performance for predicting DMFS in patients with locoregionally advanced NPC.

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Abbreviations

AUC:

Area under the receiver operating characteristic

DMFS:

Distant metastasis-free survival

GTVnd:

Lymph node gross tumor volume

GTVnx:

Gross tumor volume of the nasopharynx

IMRT:

Intensity-modulated radiotherapy

NPC:

Nasopharyngeal carcinoma

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Funding

This work was supported by the National Natural Science Foundation of China (no.: 81760546), the Scientific Research and Technology Development Program of Guilin (no.: 20170109-22), the Natural Science Foundation Key Projects of Guangxi (no.: 2018GXNSFDA050021), the Key Research and Development Program of Guangxi (AB19110016), the General Program of Guangxi Natural Science Foundation of China (no.: 2018GXNSFAA138100), and CSCO Youth Innovative Oncology Research Fund (Y-Young2020-0520).

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Authors and Affiliations

  1. Department of Oncology, Xiangya Hospital, Central South University, 410008, Changsha, China

    Huiyun Yang

  2. Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, 541001, Guilin, China

    Rongjun Zhang, Ruyun Zhang, Yuan Xie, Guanjie Qin, Yunyan Mo, Xiaolan Ruan &  Wei Jiang

  3. Department of Radiation Oncology, Wuzhou Red Cross Hospital, 543002, Wuzhou, China

    Bin Zhang

Authors
  1. Huiyun Yang
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  2. Rongjun Zhang
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  3. Ruyun Zhang
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  4. Bin Zhang
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  5. Yuan Xie
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  8. Xiaolan Ruan
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  9. Wei Jiang
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Contributions

Design and scheduling of the research: WJ; collection and sorting of data: RJZ, BZ, and YX; statistical and prognostic analysis of data: HYY, GJQ, and YYM; writing and revising the article: HYY and XLR.

Corresponding author

Correspondence to Wei Jiang.

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Conflict of interest

H. Yang, R. Zhang, R. Zhang, B. Zhang, Y. Xie, G. Qin, Y. Mo, X. Ruan, and W. Jiang declare that they have no competing interests.

Ethical standards

The study was performed following the Declaration of Helsinki. Written informed consent for participation and publication was obtained from participants. The institutional review board of Guilin Medical University approved the study. The ethics approval number was GLMU1A2018062.

Additional information

The authors Huiyun Yang, Rongjun Zhang, and Ruyun Zhang contributed equally to the manuscript.

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Yang, H., Zhang, R., Zhang, R. et al. Nomogram for distant metastasis-free survival in patients with locoregionally advanced nasopharyngeal carcinoma. Strahlenther Onkol 198, 828–837 (2022). https://doi.org/10.1007/s00066-022-01926-1

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