| Yang Song,Ge Wang,Chuan Chen,Yun Liu,Bin Wang. Predictive value of tumor volume reduction rates before and after induction chemotherapy in determining the radiosensitivity and prognosis of locally advanced nasopharyngeal carcinomas. Oncol Transl Med, 2019, 5: 12-18. |
| Predictive value of tumor volume reduction rates before and after induction chemotherapy in determining the radiosensitivity and prognosis of locally advanced nasopharyngeal carcinomas |
| Received:December 18, 2018 Revised:January 23, 2019 |
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| KeyWord:nasopharyngeal carcinomas; induction chemotherapy; radiosensitivity; prognosis |
| Author Name | Affiliation | E-mail | | Yang Song | Institute of Surgery Research, Third Affiliated Hospital, Army Medical University (Third Military Medical University) | coco7520@163.com | | Ge Wang | Cancer Center, Institute of Surgery Research, Third Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, China | | | Chuan Chen | Cancer Center, Institute of Surgery Research, Third Affiliated Hospital, Army Medical University (Third Military Medical University) | | | Yun Liu | Cancer Center, Institute of Surgery Research, Third Affiliated Hospital, Army Medical University (Third Military Medical University) | | | Bin Wang | Cancer Center, Institute of Surgery Research, Third Affiliated Hospital, Army Medical University (Third Military Medical University) | |
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| Abstract: |
| Objective This study investigated the predictive value of tumor volume reduction rates (TVRRs) before
and after induction chemotherapy in determining the radiosensitivity and prognosis of patients with locally
advanced nasopharyngeal carcinomas (NPCs).
Methods The clinical data of 172 patients with locally advanced primary NPCs who were treated from
January 2009 to December 2012 were collected. Tumor regression was evaluated based on the results of
the computed tomography scan or magnetic resonance imaging studies. Data about the tumor diameters
before and after induction chemotherapy and after radiotherapy as well as the survival times of the patients
were obtained.
Results All 172 patients had NPCs. After radiotherapy, the TVRR in patients without residual tumor cells
was higher than that in patients with residual tumor cells after induction chemotherapy (median values:
47.7% and 15.1%, respectively), and the 5-year survival rates were 80.3% and 45.6%, respectively. Neck
lymph node metastasis was observed in 161 of 172 patients, and the TVRRs were similar (median values:
46.8% in 161 patients without residual tumor cells and 11.1% in 161 patients with residual tumor cells). The
5-year survival rate of the 161 patients without residual tumor cells was 84.5%, and that of patients with
residual tumor cells was 37.3%. As shown by the receiver operating characteristic (ROC) curve, the area
under the curve (AUC) of the ROC curve for TVRRs in patients with primary NPCs but without residual
tumors was 0.851, whereas that for TVRRs in patients with neck lymph node metastasis but without residual
tumors was 0.784. This result indicates that TVRR has a high diagnostic performance. The univariate Cox
regression analysis showed that clinical stage, TVRR in primary NPCs, neck lymph node metastatic lesions
before and after induction chemotherapy, presence or absence of residual tumor cells in primary NPCs, and
neck lymph node metastatic lesions after radiotherapy were significantly correlated to overall survival (OS).
Results of the multivariate Cox regression analysis showed that clinical stage and presence or absence of
residual tumor cells in the lymph nodes after radiotherapy were the independent prognostic factors of OS.
Conclusion The TVRR after induction chemotherapy may be an effective predictive indicator of the
treatment efficacy of radiotherapy in patients with NPC. |
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