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Risk factors and prediction-score model for distant metastasis in nasopharyngeal carcinoma treated with intensity-modulated radiotherapy

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Tumor Biology

Abstract

The objective of this study is to identify the risk factors and construct a prediction-score model for distant metastasis (DM) in nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT). A total of 520 nonmetastatic NPC patients were analysed retrospectively. The independent risk factors for DM were tested by multivariate Cox regression analysis. The prediction-score model was established according to the regression coefficient. The median follow-up was 88.4 months. The 5-year DM rate was 15.1 %. N2–3, primary tumour volume of nasopharynx (GTVnx) >24.56 cm3, haemoglobin change after treatment (ΔHGB) >25.8 g/L, albumin-globulin ratio (AGR) ≤1.34, pretreatment neutrophil-lymphocyte ratio (NLR) >2.81 and pretreatment serum lactate dehydrogenase (LDH) >245 U/L were significantly adverse independent predictive factors for DM. Three subgroups were defined based on the prediction-score model: low risk (0–2), intermediate risk (3–4) and high risk (5–8). The 5-year DM rates were 4.6, 21.8 and 50.8 %, respectively (P < 0.001). The areas under the curve for DM in the prediction-score model and the UICC/AJCC staging system seventh edition were 0.748 and 0.627, respectively (P < 0.001). The scoring model is useful in evaluating the risk of DM in IMRT-treated NPC patients and guiding future therapeutic trials. Further prospective study is needed.

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    Authors and Affiliations

    1. State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China

      An-Chuan Li, Wei-Wei Xiao, Lin Wang, Guan-Zhu Shen, An-An Xu, Yan-Qing Cao, Shao-Min Huang, Cheng-Guang Lin, Fei Han, Xiao-Wu Deng & Chong Zhao

    2. Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, 350001, China

      An-Chuan Li

    3. Department of Radiation Oncology, Cancer Center of Guangzhou Medical University, Guangzhou, 510095, China

      An-An Xu

    4. Department of Radiation Oncology, The First Affiliated Hospital of Clinical Medicine of Guangdong Pharmaceutical University, Guangzhou, 510080, China

      Yan-Qing Cao

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    1. An-Chuan Li
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    Correspondence to Chong Zhao.

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    Fei Han, Xiao-Wu Deng and Chong Zhao contributed equally to this work.

    An-Chuan Li and Wei-Wei Xiao contributed equally to this work.

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    Li, AC., Xiao, WW., Wang, L. et al. Risk factors and prediction-score model for distant metastasis in nasopharyngeal carcinoma treated with intensity-modulated radiotherapy. Tumor Biol. 36, 8349–8357 (2015). https://doi.org/10.1007/s13277-015-3574-0

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