Junni Chen, B. Yuan, Shiping Yang, Jiawei Chen, Xian-gan Lin, Zhao-jun Li, F. Chen, Zhenping Wang, Fen Wang, Yiming Wang
{"title":"高危因素结合分层分析预测N2-3M0鼻咽癌患者临床预后的临床价值分析","authors":"Junni Chen, B. Yuan, Shiping Yang, Jiawei Chen, Xian-gan Lin, Zhao-jun Li, F. Chen, Zhenping Wang, Fen Wang, Yiming Wang","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.12.002","DOIUrl":null,"url":null,"abstract":"Objective \nTo evaluate the clinical value of high-risk factors in combination with stratification method in predicting the clinical prognosis of patients diagnosed with N2-3M0 nasopharyngeal carcinoma (NPC). \n \n \nMethods \nA total of 226 N2-3M0 NPC patients who underwent IMRT from November 2013 to May 2015 were enrolled in this study. The relationship between tumor volume, cervical metastatic lymph node characteristics (necrosis and fusion) and T and N staging was analyzed. The high-risk factors that affected the survival were identified. The value of high-risk factors combined with stratification method in predicting the clinical prognosis was assessed. \n \n \nResults \nN3 staging, Vn≥47.15cm3 and lymph node fusion (LNF) were the high-risk factors for distant metastasis in patients with stage N2-3M0 NPC. All patients were classified into the low-risk, medium-risk, high-risk and extremely high-risk groups according to high-risk factors. For patients in the low-risk, medium-risk, high-risk and extremely high-risk groups, the 3-year overall survival rates were 84.2%, 76.7%, 58.7% and 36.4%(all P<0.001), 87.3%, 85.2%, 54.5% and 12.1% for the distant metastasis-free survival (DMFS) rates (all P<0.001), 76.8%, 74.3%, 49.2% and 12.1%for the progression-free survival (PFS) rates (all P<0.001), and 89.2%, 88.5%, 91.5% and 88.3% for the loco-regional recurrence-free survival (LRRFS) rates (P=0.914), respectively. The risk stratification method showed the best curve separation for DMFS compared to the Vn, N staging and LNF classification groups (all P<0.05). \n \n \nConclusion \nHigh-risk factors in combination with stratification method has the highest clinical value in predicting the clinical prognosis of N2-3M0 NPC patients. \n \n \nKey words: \nNasopharyngeal neoplasm; High-risk factors combined with stratification method; Clinical value","PeriodicalId":10288,"journal":{"name":"中华放射肿瘤学杂志","volume":"28 1","pages":"885-889"},"PeriodicalIF":0.0000,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Analysis of clinical value of high-risk factors combined with stratification analysis in predicting clinical prognosis of N2-3M0 nasopharyngeal carcinoma patients\",\"authors\":\"Junni Chen, B. Yuan, Shiping Yang, Jiawei Chen, Xian-gan Lin, Zhao-jun Li, F. Chen, Zhenping Wang, Fen Wang, Yiming Wang\",\"doi\":\"10.3760/CMA.J.ISSN.1004-4221.2019.12.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective \\nTo evaluate the clinical value of high-risk factors in combination with stratification method in predicting the clinical prognosis of patients diagnosed with N2-3M0 nasopharyngeal carcinoma (NPC). \\n \\n \\nMethods \\nA total of 226 N2-3M0 NPC patients who underwent IMRT from November 2013 to May 2015 were enrolled in this study. The relationship between tumor volume, cervical metastatic lymph node characteristics (necrosis and fusion) and T and N staging was analyzed. The high-risk factors that affected the survival were identified. The value of high-risk factors combined with stratification method in predicting the clinical prognosis was assessed. \\n \\n \\nResults \\nN3 staging, Vn≥47.15cm3 and lymph node fusion (LNF) were the high-risk factors for distant metastasis in patients with stage N2-3M0 NPC. All patients were classified into the low-risk, medium-risk, high-risk and extremely high-risk groups according to high-risk factors. For patients in the low-risk, medium-risk, high-risk and extremely high-risk groups, the 3-year overall survival rates were 84.2%, 76.7%, 58.7% and 36.4%(all P<0.001), 87.3%, 85.2%, 54.5% and 12.1% for the distant metastasis-free survival (DMFS) rates (all P<0.001), 76.8%, 74.3%, 49.2% and 12.1%for the progression-free survival (PFS) rates (all P<0.001), and 89.2%, 88.5%, 91.5% and 88.3% for the loco-regional recurrence-free survival (LRRFS) rates (P=0.914), respectively. The risk stratification method showed the best curve separation for DMFS compared to the Vn, N staging and LNF classification groups (all P<0.05). \\n \\n \\nConclusion \\nHigh-risk factors in combination with stratification method has the highest clinical value in predicting the clinical prognosis of N2-3M0 NPC patients. \\n \\n \\nKey words: \\nNasopharyngeal neoplasm; High-risk factors combined with stratification method; Clinical value\",\"PeriodicalId\":10288,\"journal\":{\"name\":\"中华放射肿瘤学杂志\",\"volume\":\"28 1\",\"pages\":\"885-889\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-12-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华放射肿瘤学杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.12.002\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华放射肿瘤学杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.12.002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Analysis of clinical value of high-risk factors combined with stratification analysis in predicting clinical prognosis of N2-3M0 nasopharyngeal carcinoma patients
Objective
To evaluate the clinical value of high-risk factors in combination with stratification method in predicting the clinical prognosis of patients diagnosed with N2-3M0 nasopharyngeal carcinoma (NPC).
Methods
A total of 226 N2-3M0 NPC patients who underwent IMRT from November 2013 to May 2015 were enrolled in this study. The relationship between tumor volume, cervical metastatic lymph node characteristics (necrosis and fusion) and T and N staging was analyzed. The high-risk factors that affected the survival were identified. The value of high-risk factors combined with stratification method in predicting the clinical prognosis was assessed.
Results
N3 staging, Vn≥47.15cm3 and lymph node fusion (LNF) were the high-risk factors for distant metastasis in patients with stage N2-3M0 NPC. All patients were classified into the low-risk, medium-risk, high-risk and extremely high-risk groups according to high-risk factors. For patients in the low-risk, medium-risk, high-risk and extremely high-risk groups, the 3-year overall survival rates were 84.2%, 76.7%, 58.7% and 36.4%(all P<0.001), 87.3%, 85.2%, 54.5% and 12.1% for the distant metastasis-free survival (DMFS) rates (all P<0.001), 76.8%, 74.3%, 49.2% and 12.1%for the progression-free survival (PFS) rates (all P<0.001), and 89.2%, 88.5%, 91.5% and 88.3% for the loco-regional recurrence-free survival (LRRFS) rates (P=0.914), respectively. The risk stratification method showed the best curve separation for DMFS compared to the Vn, N staging and LNF classification groups (all P<0.05).
Conclusion
High-risk factors in combination with stratification method has the highest clinical value in predicting the clinical prognosis of N2-3M0 NPC patients.
Key words:
Nasopharyngeal neoplasm; High-risk factors combined with stratification method; Clinical value
期刊介绍:
The Chinese Journal of Radiation Oncology is a national academic journal sponsored by the Chinese Medical Association. It was founded in 1992 and the title was written by Chen Minzhang, the former Minister of Health. Its predecessor was the Chinese Journal of Radiation Oncology, which was founded in 1987. The journal is an authoritative journal in the field of radiation oncology in my country. It focuses on clinical tumor radiotherapy, tumor radiation physics, tumor radiation biology, and thermal therapy. Its main readers are middle and senior clinical doctors and scientific researchers. It is now a monthly journal with a large 16-page format and 80 pages of text. For many years, it has adhered to the principle of combining theory with practice and combining improvement with popularization. It now has columns such as monographs, head and neck tumors (monographs), chest tumors (monographs), abdominal tumors (monographs), physics, technology, biology (monographs), reviews, and investigations and research.