诱导化疗前后肿瘤体积在局部晚期鼻咽癌中的预后价值比较
Comparative Prognostic Value of Pre- and Post-Induction Chemotherapy Tumor Volumes in Locoregionally Advanced Nasopharyngeal Carcinoma.
文献信息
| PMID | 42755062 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yao Yin |
| 作者单位 | Department of Oncology, Xiangya Hospital, Central South University, Changsha, China. |
| 期刊 | Cancer research and treatment |
| SCI 分区 | Q2 |
| IF | 4.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻咽癌 |
中文摘要
目的： 评估并比较接受多西他赛联合顺铂（DP方案）诱导化疗（IC）后同步放化疗（CCRT）治疗的局部晚期鼻咽癌（LANPC）患者中，诱导化疗前后原发灶、淋巴结及总肿瘤体积的预后价值。
材料与方法： 我们回顾性分析了2016年至2020年的164例LANPC患者。在诱导化疗前后测量原发肿瘤体积（GTV-P）、淋巴结肿瘤体积（GTV-N）和总肿瘤体积（GTV-T，GTV-T = GTV-P + GTV-N）。使用Cox比例风险模型分析肿瘤体积与总生存期（OS）和无进展生存期（PFS）的关联，而局部区域无复发生存期（LRRFS）和远处无转移生存期（DMFS）则使用Fine-Gray竞争风险模型进行评估。使用一致性指数（C-index）和赤池信息量准则（AIC）评估预后区分度，并使用Kaplan-Meier分析进行风险分层。
结果： 诱导化疗后的体积参数显示出优于诱导化疗前体积参数的预后价值。诱导化疗后总肿瘤体积（GTV-T_post）与OS和PFS独立相关，并表现出最佳的模型性能。诱导化疗后原发肿瘤体积（GTV-P_post）与LRRFS相关，而诱导化疗后淋巴结肿瘤体积（GTV-N_post）与DMFS相关。Kaplan-Meier分析进一步证实了基于诱导化疗后肿瘤体积对不同生存终点的风险分层价值。
结论： 诱导化疗后残留肿瘤体积比治疗前和衍生的体积变化参数显示出更大的预后价值。残留原发和淋巴结肿瘤体积分别与局部区域复发和远处转移显著相关。纳入诱导化疗后体积评估可能改善风险分层并指导个体化治疗策略。
英文摘要
PURPOSE: To evaluate and compare the prognostic value of primary, nodal, and total tumor volumes before and after induction chemotherapy (IC) in patients with locoregionally advanced nasopharyngeal carcinoma (LANPC) treated with docetaxel plus cisplatin (DP regimen) IC followed by concurrent chemoradiotherapy (CCRT).
MATERIALS AND METHODS: We retrospectively analyzed 164 patients with LANPC from 2016 to 2020. Primary tumor volume (GTV-P), nodal tumor volume (GTV-N), and total tumor volume (GTV-T, GTV-T = GTV-P + GTV-N) were measured before and after IC. The association between tumor volumes and overall survival (OS) and progression-free survival (PFS) was analyzed using Cox proportional hazards models, while locoregional relapse-free survival (LRRFS) and distant metastasis-free survival (DMFS) were assessed using Fine-Gray competing-risk models. Prognostic discrimination was assessed using the concordance index (C-index) and the Akaike information criterion (AIC), and risk stratification was performed using Kaplan-Meier analysis.
RESULTS: Post-IC volumetric parameters showed superior prognostic value than pre-IC volumetric parameters. Post-IC total tumor volume (GTV-T_post) was independently associated with OS and PFS and demonstrated the best model performance. Post-IC primary tumor volume (GTV-P_post) was associated with LRRFS, whereas post-IC nodal tumor volume (GTV-N_post) was associated with DMFS. Kaplan-Meier analysis further confirmed the value of risk stratification based on post-IC tumor volumes for different survival endpoints.
CONCLUSION: Post-IC residual tumor volume showed greater prognostic value than pretreatment and derived volumetric change parameters. Residual primary and nodal tumor volumes were distinctly associated with locoregional recurrence and distant metastasis, respectively. Incorporation of post-IC volumetric assessment may improve risk stratification and guide individualized treatment strategies.