| 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. |
| 诱导化疗前后肿瘤退缩率对局部晚期鼻咽癌放射敏感性及预后影响的研究 |
| 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 |
| DOI：10.1007/s10330-018-0326-6 |
| 中文关键词: 鼻咽癌;诱导化疗;放射敏感性;预后 |
| 英文关键词: nasopharyngeal carcinomas; induction chemotherapy; radiosensitivity; prognosis |
| 基金项目: |
| 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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| 中文摘要: |
| 目的 探讨局部晚期鼻咽癌诱导化疗前后肿瘤退缩率对放疗敏感性及预后的预测作用。方法 收集2 009年1月-2012年12月172例初治局部晚期鼻咽癌患者临床资料并通过影像结果评估肿瘤退缩情况，收集患者诱导化疗前后、放疗后肿瘤直径，和患者的生存时间。结果 172例患者均存在鼻咽部肿瘤病灶，放疗后无肿瘤残余组中诱导化疗后肿瘤退缩率显著高于有残余肿瘤组（中位值：47.7% VS 15.1%）,5年生存率（80.3 VS 45.6%）。161例患者存在颈部淋巴结转移病灶，有相似的结果（中位值：46.8% VS 11.1%），5年生存率（84.5% VS 37.3%）。ROC曲线分析鼻咽部原发病灶肿瘤退缩率对无肿瘤残余的ROC曲线下面积为0.851，颈部转移淋巴结肿瘤退缩率对无肿瘤残余的ROC曲线下面积为0.784，均具有较高的诊断效能。单因素Cox回归分析表明，临床分期、诱导化疗前后鼻咽部原发病灶和淋巴结转移灶退缩率以及放疗后鼻咽部原发病灶和淋巴结转移灶有无肿瘤残余均与总生存有显著相关性。多因素Cox回归分析表明临床分期和放疗后淋巴结有无肿瘤残余是OS的独立预后因素。 结论 鼻咽癌诱导化疗后肿瘤退缩率可能成为放疗后疗效的有效预测指标。 |
| 英文摘要: |
| 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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