Prognostic value of tumor volume for patients with nasopharyngeal carcinoma treated with concurrent chemotherapy and intensity-modulated radiotherapy

  • Zheng Wu
  • Yong Su
  • Rui-Fang Zeng
  • Mo-Fa Gu
  • Shao-Min Huang
Original Paper



We aimed to analyze prognostic factors in patients with nasopharyngeal carcinoma (NPC) treated with concurrent chemotherapy and intensity-modulated radiotherapy (IMRT); in addition, we aimed to elucidate the value of primary gross tumor volume (GTVp) in predicting prognosis of patients.


Between February 2001 and December 2008, 321 patients with NPC treated with concurrent chemotherapy and IMRT were analyzed retrospectively. GTVp was calculated from treatment planning computed tomography scans. A receiver operating characteristics (ROC) curve was used to determine the best cutoff point of GTVp.


The 5-year local failure-free survival (LFFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) for NPC patients were 93.8, 80.1, 73.0, and 83.7 %, respectively. Univariate and multivariate analyses indicated that GTVp had exhibited a statistically significant correlation with LFFS, DMFS, DFS, and OS (P < 0.05, all), whereas T classification was not an independent prognostic factor. According to ROC curve analysis, 49 and 19 mL were determined as the cutoff points of GTVp for local control and distant metastasis, respectively. Based on this, 321 patients were divided into three volume subgroups. LFFS, DMFS, DFS, and OS demonstrated significant differences among patients in different volume subgroups (P < 0.001, all) and were superior to T classification for predicting prognosis of NPC patients.


Primary gross tumor volume is an independent prognostic factor in local control, distant metastasis, disease-free survival, and overall survival in NPC. An adjusted TNM staging system that includes GTVp as a quantitative indicator to evaluate prognosis is warranted.


Nasopharyngeal carcinoma Intensity-modulated radiotherapy Primary tumor volume Concurrent chemotherapy Prognosis 



This work was supported by the Planned Science and Technology Project of Guangdong Province (No. 2010B080701016 and No. 2012B031800301).

Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Zheng Wu
    • 2
  • Yong Su
    • 1
  • Rui-Fang Zeng
    • 3
  • Mo-Fa Gu
    • 1
  • Shao-Min Huang
    • 1
  1. 1.State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer CenterSun Yat-sen UniversityGuangzhouPeople’s Republic of China
  2. 2.Department of Radiation Oncology, Tumor Hospital, Xiangya School of MedicineCentral South UniversityChangshaPeople’s Republic of China
  3. 3.Department of Oncology, The First Affiliated HospitalSun Yat-sen UniversityGuangzhouPeople’s Republic of China

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