Abstract:
OBJECTIVES:Induction chemotherapy (IC) is gaining recognition for the treatment of nasopharyngeal carcinoma (NPC). We aimed to develop a model to predict benefit from additional IC to concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS:From an NPC-specific database, 7413 patients with stage II-IVa disease who received CCRT with or without IC were included. Distant metastasis-free survival (DMFS) was the primary outcome and benefit from IC was evaluated by adjusted hazard ratio. Interaction terms between IC and other prognostic factors were identified in multivariate Cox model, and IC benefit score (ICBS) was calculated based on β coefficients from the Cox model. RESULTS:Nodal category, overall stage, and pre-treatment plasma Epstein-Barr virus DNA (log transformed as continuous variable) interacted with IC and determined ICBS. ICBS could discriminate patients who benefited differently from IC in terms of DMFS well, especially for patients with high and low ICBS. As for patients with medium ICBS, predictive performance of ICBS seemed reduced. CONCLUSIONS:Based on the ICBS model, we proposed a decision-making process to help in clinical practice. Multi-institutional and prospective studies are warranted to further validate our findings.
journal_name
Oral Oncoljournal_title
Oral oncologyauthors
Peng L,Chen YP,Xu C,Tang LL,Chen L,Lin AH,Liu X,Sun Y,Ma Jdoi
10.1016/j.oraloncology.2018.10.007subject
Has Abstractpub_date
2018-11-01 00:00:00pages
258-265eissn
1368-8375issn
1879-0593pii
S1368-8375(18)30359-2journal_volume
86pub_type
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