Yuan Zhang1, Wen-Fei Li1, Xu Liu1, Lei Chen1, Rui Sun1, Ying Sun1, Qing Liu2, Jun Ma3. 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China. 2. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China. 3. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China. Electronic address: majun2@mail.sysu.edu.cn.
Abstract
BACKGROUND AND PURPOSE: Recent clinical trials and network meta-analysis have suggested that the addition of induction chemotherapy (IC) to concurrent chemoradiotherapy (CCRT) could improve survival in locoregionally advanced NPC (LANPC). We aimed to develop a nomogram to estimate the benefit of IC for individual patients based on the data from a multicenter, randomized, phase III trial (NCT01245959) comparing IC plus CCRT with CCRT alone. PARTICIPANTS AND METHODS: This study analyzed all 480 patients enrolled in the original trial. A nomogram was developed to predict 3-year failure-free survival (FFS) with or without IC. RESULTS: With a median follow-up of 45 months, the 3-year FFS rates were 80.3% and 72.4% in the IC plus CCRT group and CCRT group, respectively (P = 0.034). In multivariate analysis, T category, N category and treatment group were predictive of FFS and were incorporated into the nomogram. Gender was also included due to its clinical importance. This nomogram predicted that the magnitude of benefit from IC could vary significantly. CONCLUSION: We developed a convenient nomogram to estimate the benefit of IC for individual patients with LANPC. This tool can serve as a catalyst of individual treatment discussions and facilitator of informed decision-making.
RCT Entities:
BACKGROUND AND PURPOSE: Recent clinical trials and network meta-analysis have suggested that the addition of induction chemotherapy (IC) to concurrent chemoradiotherapy (CCRT) could improve survival in locoregionally advanced NPC (LANPC). We aimed to develop a nomogram to estimate the benefit of IC for individual patients based on the data from a multicenter, randomized, phase III trial (NCT01245959) comparing IC plus CCRT with CCRT alone. PARTICIPANTS AND METHODS: This study analyzed all 480 patients enrolled in the original trial. A nomogram was developed to predict 3-year failure-free survival (FFS) with or without IC. RESULTS: With a median follow-up of 45 months, the 3-year FFS rates were 80.3% and 72.4% in the IC plus CCRT group and CCRT group, respectively (P = 0.034). In multivariate analysis, T category, N category and treatment group were predictive of FFS and were incorporated into the nomogram. Gender was also included due to its clinical importance. This nomogram predicted that the magnitude of benefit from IC could vary significantly. CONCLUSION: We developed a convenient nomogram to estimate the benefit of IC for individual patients with LANPC. This tool can serve as a catalyst of individual treatment discussions and facilitator of informed decision-making.
Authors: Marco Siano; Pavel Dulguerov; Martina A Broglie; Guido Henke; Paul Martin Putora; Christian Simon; Daniel Zwahlen; Gerhard F Huber; Giorgio Ballerini; Lorenza Beffa; Roland Giger; Sacha Rothschild; Sandro V Negri; Olgun Elicin Journal: Front Oncol Date: 2019-10-24 Impact factor: 6.244