The prognostic value of volumetric reduction of the target lesions after induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma

Head Neck. 2019 Jun;41(6):1863-1872. doi: 10.1002/hed.25620. Epub 2019 Jan 8.

Abstract

Background: We explored whether the volumetric reduction ratio of target lesion after induction chemotherapy (IC) had any prognostic value in nasopharyngeal carcinoma (NPC).

Methods: From 2013 to 2016, 72 NPC patients treated with PCF (paclitaxel, cisplatin, 5-fluorouracil) IC followed by cisplatin-based concurrent chemoradiotherapy were analyzed. The volumes of target lesions before and after IC and survival conditions were assessed.

Results: For all cases, volumetric reduction ratios of the total tumor load ≥ optimal cutoff values were significantly associated with increased 2-year progression-free survival, locoregional failure-free survival, and distant metastasis-free survival (DMFS) rates, and for cervical lymph nodes, the volumetric reduction ratio ≥ optimal cutoff value was significant for DMFS (all P < .05). Accordingly, the optimal cutoff values were 24.56% (AUC = 60.5%), 23.91% (AUC = 57.7%), 29.77% (AUC = 75.8%), and 34.17% (AUC = 62.5%), respectively.

Conclusion: Volumetric reductions of target lesions after IC are independent survival predictors for NPC, especially for those with N2/N3 disease.

Keywords: computed tomography localization; induction chemotherapy; nasopharyngeal carcinoma; prognostic prediction; volumetric reduction ratio.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols
  • Female
  • Humans
  • Induction Chemotherapy*
  • Male
  • Middle Aged
  • Nasopharyngeal Carcinoma / drug therapy*
  • Nasopharyngeal Carcinoma / mortality
  • Nasopharyngeal Carcinoma / pathology*
  • Nasopharyngeal Neoplasms / drug therapy*
  • Nasopharyngeal Neoplasms / mortality
  • Nasopharyngeal Neoplasms / pathology*
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Young Adult

Substances

  • Antineoplastic Agents