Prognosis viewing for nasopharyngeal carcinoma treated with intensity-modulated radiation therapy: application of nomogram and decision curve analysis.

To view and evaluate the prognosis factors in patients with nasopharyngeal carcinoma (NPC) treated with intensity modulated radiation therapy using nomogram and decision curve analysis (DCA). Based on a primary cohort comprising consecutive patients with newly confirmed NPC (n = 1140) treated between January 2014 and December 2015, we identified independent prognostic factors of overall survival (OS) to establish a nomogram. The model was assessed by bootstrap internal validation and external validation in an independent validation cohort of 460 patients treated between January 2013 and December 2013. The predictive accuracy and discriminative ability were measured by calibration curve, concordance index (C-index) and risk-group stratification. The clinical usefulness was assessed by DCA. The nomogram incorporated T-stage, N-stage, age, concurrent chemotherapy and primary tumour volume (PTV). The calibration curve presented good agreement for between the nomogram-predicted OS and the actual measured survival probability in both the primary and validation cohorts. The model showed good discrimination with a C-index of 0.741 in the primary cohort and 0.762 in the validation cohort. The survival curves of different risk-groups were separated clearly. Decision curve analysis demonstrated that the nomogram provided a higher net benefit (NB) across a wider reasonable range of threshold probabilities for predicting OS. This study presents a predictive nomogram model with accurate prediction and independent discrimination ability compared with combination of T-stage and N-stage. The results of DCA supported the point that PTV can help improve the prognostic ability of T-stage and should be added to the TNM staging system.

Fei Z ，Qiu X ，Li M ，Chen C ，Li Y ，Huang Y ... -  《-》

The value of detailed MR imaging report of primary tumor and lymph nodes on prognostic nomograms for nasopharyngeal carcinoma after intensity-modulated radiotherapy.

To establish effective prognostic nomograms using clinical features and detailed magnetic resonance imaging (MRI) findings for primary tumor and regional lymph nodes after intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma. The nomogram for overall survival (OS) was based on a retrospective study of 595 patients who underwent IMRT at Sun Yat-sen University Cancer Center from 2010 to 2012. The predictive accuracy and discriminative ability of our nomogram models were determined by concordance index and calibration curve, and were compared with the nomogram models combining clinical features with tumor-node-metastasis (TNM) classification. The results were validated using bootstrap resampling and a cohort study of 241 patients. The same data cohort was used to predict the progress-free survival (PFS) of nasopharyngeal carcinoma with 3:1 training cohort (N = 558) and validation cohort (N = 278). The following factors were assembled into our prognostic survival nomogram models: Age, Epstein-Barr virus DNA copy number before treatment (EBV_DNA_CN), tensor veli palatini (TVP) involvement, musculus pterygoideus lateralis (MPL) involvement, prestyloid space (PS) involvement, prevertebral space (PVS) involvement, base of sphenoid bone (BOSB) involvement, paranasal sinus (PNS) involvement, the laterality of Ⅱ (Ⅱ_laterality), the laterality of retropharyngeal lymph node (RPLN_laterality), nodal grouping (NG), extranodal neoplastic spread (ENS), contrast-enhancing rim (CER) and Nodal_number. The calibration curves showed good agreement between nomogram-predicted and actual survival. Our nomogram models for OS and PFS, provided better results than the nomogram models combining clinical features with TNM classification. Results were further confirmed in the validation set. Detailed MRI findings of primary tumor and regional lymph nodes can improve the performance of prognostic nomograms for patients with nasopharyngeal carcinoma.

Wan Y ，Tian L ，Zhang G ，Xin H ，Li H ，Dong A ，Liang Y ，Jing B ，Zhou J ，Cui C ，Chen M ，Sun Y ，Xie C ，Liu L ，Shao Y ... -  《-》

Prognostic Nomogram For Locoregionally Advanced Nasopharyngeal Carcinoma.

Jiang Y ，Qu S ，Pan X ，Huang S ，Zhu X ... -  《-》

Prognostic Nomogram for Patients with Nasopharyngeal Carcinoma after Intensity-Modulated Radiotherapy.

Wu S ，Xia B ，Han F ，Xie R ，Song T ，Lu L ，Yu W ，Deng X ，He Q ，Zhao C ，Xie C ... -  《PLoS One》

Development and validation of a nomogram for predicting the survival of patients with non-metastatic nasopharyngeal carcinoma after curative treatment.

Liang W ，Shen G ，Zhang Y ，Chen G ，Wu X ，Li Y ，Li A ，Kang S ，Yuan X ，Hou X ，Huang P ，Huang Y ，Zhao H ，Tian Y ，Zhao C ，Zhang L ... -  《-》