Tumor Biology

, Volume 36, Issue 11, pp 8349–8357 | Cite as

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

  • 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
Research Article


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.


Nasopharyngeal carcinoma Prediction-score model Distant metastasis Intensity-modulated radiotherapy 


Conflicts of interest


Supplementary material

13277_2015_3574_MOESM1_ESM.docx (19 kb)
ESM 1 (DOCX 19 kb)


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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • An-Chuan Li
    • 1
    • 2
  • Wei-Wei Xiao
    • 1
  • Lin Wang
    • 1
  • Guan-Zhu Shen
    • 1
  • An-An Xu
    • 1
    • 3
  • Yan-Qing Cao
    • 1
    • 4
  • Shao-Min Huang
    • 1
  • Cheng-Guang Lin
    • 1
  • Fei Han
    • 1
  • Xiao-Wu Deng
    • 1
  • Chong Zhao
    • 1
  1. 1.State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer MedicineSun Yat-sen University Cancer CenterGuangzhouChina
  2. 2.Department of Radiation OncologyFujian Medical University Union HospitalFuzhouChina
  3. 3.Department of Radiation OncologyCancer Center of Guangzhou Medical UniversityGuangzhouChina
  4. 4.Department of Radiation OncologyThe First Affiliated Hospital of Clinical Medicine of Guangdong Pharmaceutical UniversityGuangzhouChina

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